Background: National Health Education Standards in the U. S. focus on key concepts and skills around health issues, including sexuality. However, little is known about the extent to which classroom teachers are trained to deliver sexuality education. Purpose: The purpose is to explore pre-service training experiences and needs of sexuality educators in Minnesota. Methods: Seven focus groups were conducted with a diverse sample of 41 sexuality educators, and qualitative analysis was used to detect themes across groups. Results: Results indicate a wide variety of pre-service teaching experience, ranging from no instruction to extensive training. Teachers had numerous suggestions for ways their training could have better prepared them to teach sexuality education, such as ways of working with culturally diverse students. Teachers described many ways in which they were unprepared in their first year of teaching sexuality education. Discussion: Training programs to prepare sexuality educators are not adequately preparing teachers for their multifaceted role. Findings point to the need to train sexuality educators differently than teachers for other subjects. Translation to Health Education Practice: Findings indicate that pre-service training programs should greatly expand their offerings, tighten requirements and hone methodologies in sexuality education to meet the needs of today's teachers and students.