Objective: To assess the sexual health knowledge of secondary school pupils in order to ascertain whether the current government public health and education policies are having any impact on pupils' sexual health. Design: Results obtained from a questionnaire as part of a two-phase intervention study. Setting: Nineteen mixed-sex, state secondary schools in central England. Participants: Year 8 pupils (350 male, 345 female), year 9 pupils (300 male, 325 female) and year 10 pupils (310 male, 329 female). Intervention: A questionnaire survey to assess the knowledge of pupils' sexual health education. Main outcome measures: Questionnaires distributed to pupils as baseline to assess their knowledge of sexual health, contraception and sexually transmitted infections. Results: Sexual health knowledge improves with age. A significant difference across all age groups was found, although knowledge regarding sexually transmitted infections and emergency contraception is poor for all age groups. Conclusions: Current sexual health education provision is not providing young people with adequate knowledge regarding sexual health and contraception. (Contains 2 tables and 1 figure.)