Positive perceptions of parent-child communication can influence behavioral outcomes such as sexual behavior and substance use among young people. Parent-child communication has been effective in modifying adverse health outcomes among heterosexual youth; however, limited research has examined the perceptions of parent-child communication among sexual minority youth, specifically African American young men who have sex with men (AAYMSM). Understanding AAYMSM's and parents' health communication perceptions and practices is critical for improving delivery of health information for this population and communication about sensitive health issues. Using mixed-methods research, the authors conducted focus groups and interviews and administered a cross-sectional survey to 42 AAYMSM and 10 parents of AAYMSM. Descriptive statistics were used to examine survey responses. Thematic analysis revealed that sexual orientation and HIV/AIDS were the most reported topics discussed among both parent and youth participants. Barriers to parent-child communication included fear, embarrassment, lack of time, and the limited availability of AAYMSM-specific health information. Recommended strategies for improving parent-child communication are discussed. Findings will assist in the development of targeted interventions to improve parent-child communication about health among AAYMSM and parents.