Background This study aimed to describe and compare the sexual and reproductive health (SRH) care utilization among young women with cystic fibrosis (CF) with the general United States (U.S.) population. Methods Women with CF ages 15–24 years from five geographically diverse U.S. CF centers participated in a survey investigating SRH. Results were summarized and compared to a nationally representative sample of young women aged 15–24 who participated in the U.S. National Survey of Family Growth (NSFG) using logistic regression to adjust for confounders. Results A total of 188 women with CF (19.7 ± 2.7 years) completed the survey; data were compared to 1997 NSFG respondents (19.6 ± 0.10 years). Women with CF had lower lifetime rates of ever obtaining a Pap smear or pelvic exam (26% vs. 57%; p < 0.001) and similar rates of HPV vaccination (44% vs. 43%; p = 0.64) compared to NSFG respondents. Thirty-seven percent of women with CF reported seeking contraception and < 10% reported contraceptive counseling, STI testing/counseling, or pregnancy testing in their lifetime. In the prior 12 months, 41% of NSFG respondents reported seeking contraception, 24% received contraceptive counseling, 22% STI testing/counseling, and 23% pregnancy testing. A minority of women with CF received or discussed SRH care in the CF setting, although 66% wanted to discuss SRH with their CF team. Conclusions Young women with CF report low rates of SRH care utilization and desire SRH discussions in the CF setting. Interventions should target improved SRH care delivery and encourage patient-provider communication around SRH in the CF care setting.