This study examines the role of condom use knowledge and attitudes, and parent-teen communication about sex and relationship quality on reports of condom use self-efficacy among rural, African American youth. Participants were 465 North Carolinian youth (10-14 years). Results indicated that greater condom use self-efficacy was predicted by greater knowledge of condom use (ß = 0.206; p < 0.001), more favorable attitudes toward condom use (ß = -0.20; p < 0.0001) and parent-teen communication about sex (ß = 0.13; p < 0.05), and actual parent-teen communication about sex and dating (ß = 0.14; p < 0.05). There was low agreement between parents and youth on measures related to parent-teen communication about sex. Findings call for interventions targeting improvement of condom use knowledge among early adolescents, as well as parent-teen communication about sex. In addition, given the low parent-teen agreement regarding sexual communication, parent-teen sexual communication is an important point of intervention.