Young people have questions about sex and development but may have trouble getting answers to them. Text messaging services can serve as a resource. This study analysed 1351 text messages sent to a sexual health text message service designed for young people in North Carolina to determine the types of questions asked of a confidential, accurate source of information. The majority of texts sought information about sexual health topics (89%). A smaller proportion asked for advice (7%) or reassurance (4%) that the sender was developing normally. Questions mainly asked about sexual acts (33.9%), unplanned pregnancy (20.2%), contraception (13.7%), physical or sexual development (12.9%) and sexually transmitted diseases (10.8%). Findings suggest that a confidential and accurate sexual health text message service could be an important resource for young people, especially if they seek advice before engaging in risky sexual behaviour. (Contains 2 tables.)