For Black girls, adolescence may be punctuated with health disparities that adversely impact their health and well-being. Considering the current context of systemic and structural racism experienced by Black adolescent females, sexual health disparities may be indicative of limited resources that promote healthy decision-making. According to the Centers for Disease Control and Prevention, Black adolescent females often report higher rates of unintended pregnancies, births, and sexually transmitted infections compared to females from other ethnic groups. Given the persistent sexual health disparities impacting the lives of many Black adolescent females, it is important to examine sexual health interventions and their abilities to comprehensively target the unique needs of Black adolescent females. A systematic review of active sexual health programs in the United States, between 2010 and 2020 that specifically target Black adolescent females, revealed few culturally relevant interventions actually address their sexual health needs. Implications for policy, practice and research are discussed.