Data were obtained from the National Longitudinal Study of Adolescent Health to examine the longitudinal association between Asian and Pacific Islander (API) adolescents' perceptions of maternal approval of their sexual activity and contraception use, and four sexual outcomes during young adulthood. The study includes a nationally representative sample of 1,195 API adolescents. Logistic regression analyses were used to estimate the associations between predictors (Wave I) and outcomes (Wave III), controlling for covariates. API adolescents who perceived that their mothers approved of their sexual activities were more likely to have engaged in sex before age 15, contracted HIV/Sexually Transmitted Diseases, had multiple sex partners, and paid money for sex during young adulthood. Findings highlight the need for parent-adolescent communication and parental involvement in preventing negative sexual health outcomes among API adolescents transitioning to young adulthood.