Background: A comprehensive review of the literature failed to find any studies to assess elementary school parents' preferred philosophical approach to teaching sexuality education and sexuality education topics discussed by parents. All previous research reported parent data for grades K-12 or grades 9-12 only. Methods: A random sample of 2400 parents of children ages 6 to 11 across 3 counties of a Midwestern state were surveyed using a 3-wave mailing, which resulted in a final response rate of 43% from eligible parents. Results: When asked to identify which of 3 sexuality education topics should be taught at specific grade levels, a plurality (36%) thought that the reproductive system should be taught in grades 3-5. Most parents (51%) supported teaching abstinence and refusal skills in grades 6-8 and supported teaching birth control and condom use (55%) in the middle school grades or earlier. Discussion: Multiple factors come into play when schools decide what sexuality education topics to include in the curriculum, including politics, moral philosophy of adults, resources, and research evidence. The results of this study support comprehensive sexuality education. Translation to Health Education Practice: Health education teachers should advocate for quality sexuality education in the middle school grades or earlier.