Background <p>Sexual and racial identity are associated with unintended pregnancy; method of contraception is a factor that warrants further exploration in addressing this trend. We test associations between sexual and racial identity on contraceptive use among young women across ages 15–21 years.</p> Methods <p>Participants were enrolled in the longitudinal, community based Pittsburgh Girls Study. The number of participants reporting sexual intercourse with a male and contraception use in the past year ranged from 226 (9.8%) at age 15 to 1,295 (56.2%) at age 21. Participants indicated the most commonly used form of contraception. Effectiveness of contraceptive methods also were categorized according to the World Health Organization definition.</p> Results <p>There was a statistically significant association between race (Black or White) and contraceptive method (χ² [3] = 148.03, <i>p &lt;</i> 0.001), with nearly 50% of White females reporting oral contraceptives as the most frequently used contraceptive compared to 20% of Black females. The overall proportions of contraceptive method significantly differed between bisexual and heterosexual females (χ² [3] = 21.29, <i>p</i> &lt; 0.001). Compared to heterosexual females, bisexual females were more likely to use male condoms and IUDs and less likely to use oral contraceptives as the most common method. Both Black racial identity and bisexual identity were associated with use of effective contraception.</p> Conclusions <p>Results from the present study expand our understanding of the impact of sexual and racial identity on contraceptive use, and suggest that such differences emerge during mid-adolescence. There may be a role for providers in ensuring that the contraceptive choices available to racial and sexual minority women are based on candid discussions about effectiveness in the context of individual goals and risks.</p>