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Though there are many evaluations of abstinence-only sex education programs in the United States, there is a relatively small body of literature exploring the programs’ impact specifically on adolescent sexual behavior. Thus, the purpose of this literature review is to examine the impact of abstinence-only sex education programs on adolescent sexual outcomes. The phrase “sexual outcomes” refers to attitudes, behaviors, and experiences of adolescents as a result of their sex education. After an overview of sex education in the United States, I discuss three major themes found in the most recent literature: abstinence and delaying the initiation of sex, consequences of the lack of contraceptive use, and lastly, the perspectives and experiences of LGBTQ+ youth. Overall, abstinence-only sex education programs are found to have no beneficial or harmful impact on rates of abstinence, STDs, and unintended pregnancies. Additionally, strong evidence suggests that abstinence-only programs adversely impact LGBTQ+ youth, largely due to the lack of relevant information and the heteronormative framing. I conclude with a brief discussion of how these findings relate back to the current policy debate, as well as suggestions for future research.