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Perceptions of siblings' sexual activity predict sexual attitudes among at-risk adolescents. OBJECTIVE: Most American youth have siblings. This study examined the influence of early adolescents' perceptions of their older sibling's sexual activity on their own sexual attitudes and behaviors. METHODS: Early adolescents (ages 12-14) at risk for emotional/behavioral problems reported on attitudes towards sex, sexual behaviors, and perception of older siblings' and peers' sexual activity and perceived parental approval toward sex. The sample was divided into 3 groups: teens who thought their older sibling was not having sex (N = 119), teens who believed their sibling was sexually active (N = 55), and teens without an older sibling (N = 170). RESULTS: Teens who thought their older sibling was not having sex scored higher in valuing abstinence and lower on perceptions of peer sex and maternal approval toward sex than teens who perceived their sibling to be having sex and teens without an older sibling. Regarding behaviors, teens who thought their older sibling was not having sex were less likely to endorse making out, touching genitals, oral sex, and vaginal sex compared with teens who thought their older sibling was having sex. CONCLUSIONS: Perceptions that older siblings abstain from sexual activity may be a protective factor for more conservative attitudes towards sex and decreased sexual activity among young at-risk teens. A single question about perceptions of siblings' sexual behaviors can be integrated into health care visits to introduce conversations about age-appropriate sexual decision-making.