This review presents a discussion of the sexual development of children and adolescents with disabilities, described in the framework of body structure and function, individual activities, and societal perspectives presented in the World Health Organization’s International Classification of Functioning, Disability and Health. Issues of sexual development, gynecological care and contraception, sexual functioning, societal barriers, sexual victimization, and sexuality education are presented. Overall, adolescents with disabilities seem to be participating in sexual relationships without adequate knowledge and skills to keep them healthy, safe, and satisfied. Although their sexual development may be hindered both by functional limitations and by intentional or unintentional societal barriers, the formal and informal opportunities for teenagers with disabilities to develop into sexually expressive and fulfilled persons do exist. Health care providers are urged to increase their awareness of this unmet need and to implement strategies that promote the physical, emotional, social, and psychosexual independence of children, teenagers, and young adults with disabilities.