This article examines the relationship between exposure to violence, fear of exposure to violence, and sexual risk among a sample of urban middle school youth. The sample included 911 seventh-grade students who completed self-report surveys. Approximately 20% of the sample reported at least one direct threat or injury with a weapon in the past 3 months, and 52% reported ever seeing someone seriously injured or killed. Experiencing a direct threat was significantly associated with greater intentions to engage in vaginal intercourse and sexual touching behaviors; witnessing violence was significantly associated with sexual touching. Fearing exposure to violence was not associated with increased sexual risk. Most associations did not differ by gender. These data highlight the potential influence of exposure to violence on sexual risk among early adolescents, and underscore the potential of addressing exposure to violence in sexuality education programs and sexual health services for enhanced impact.