This paper examines gender differentials in adolescent sexual activity and reproductive health risks in urban Cameroon. The results show that males become sexually active at an earlier age than females, but that age at first intercourse is declining among females. Peer influence encourages early sexual initiation, but being enrolled in school delays it. Many youths, especially males aged 18–22, engaged in risky sexual practices, including exchanging gifts or money for sex and having multiple partners. Although most youths have tried condoms, current use has remained low, suggesting that its use is inconsistent or that it varies by partner. Data on abortions and STDs highlight the need for additional and better programmes that specifically address adolescent and young adult reproductive health problems.(Afr J Reprod Health 1999; 3 [2]: 51-67)