Most research on sexuality courses in US higher education was conducted in the 1980s and 1990s. Less is known about what is being taught in undergraduate sexuality courses today; this study sought to fill that gap. Reviewing content based on 161 courses (provided by 150 different instructors) from all regions of the USA, this study examined overall descriptions of course content and pedagogical strategies in relation to the academic position of the instructor, region of the country and course enrolment size. Results indicated similar content and pedagogical strategies employed with limited differences based on demographic characteristics. The most commonly taught subjects were sexual orientation (95.0%), communication (93.8%), gender identity (93.2%) and gender roles (93.2%). Most courses included reference to contraception (89.4%), HIV and AIDS (88.2%) and STIs (85.7%). Some notable differences included the fact that tenured or tenure-track instructors were more likely to lecture compared to non-tenure-track instructors, and 100% of courses in the West and Northeast addressed sexual orientation compared to 96% for the Midwest and 85% for the South. Most courses included discussion of pleasure (91.1%) and incorporated sexually explicit content (61.9%). The benefits and challenges of having guidelines for sexuality courses at the university/college level were explored.