AbstractParent–adolescent sexual communication can help reduce sexual risk behaviors among adolescents. However, research and theory are less clear regarding the specific pathways (i.e., mechanisms of change) by which this communication works to reduce sexual risk behavior. The current review addresses this gap by proposing a conceptual model describing the processes by which par ent–adolescent sexual communication influences adoles-cents’ sexual intentions and behaviors and by conducting a systematic review to locate evidence for this model. Gui-ded by the Integrative Model of Behavioral Change, the proposed conceptual model focuses on the social cognitive pathways that act as explanatory mechanisms of the rela-tions between parent–adolescent sexual communication and adolescents’ sexual intentions and behaviors, as well as the characteristics of this communication that determine its effectiveness in influencing these sexual cognitions. Thirty-eight peer-reviewed studies were systematically located and synthesized. Findings showed consistent links between parent–adolescent sexual communication and adolescents’ sexual attitudes and safe-sex efficacy (though links with perceived sexual norms were more mixed), which in turn may influence their sexual intentions and behaviors. Evi-dence also emerged to suggest that the characteristics of the communication itself (e.g., extent, content, quality) may influence its effectiveness over adolescents’ sexual cogni-tions. The identification of these processes advances theory on parent–adolescent sexual communication which has, to date, been unclear regarding these pathways. As such, these findings can inform future research efforts as well as pre-vention efforts seeking to promote adolescent sexual health. KeywordsParent–adolescent sexual communication Parent–child communication Sexual behavior Sexual risk  Parent–child relationship