This chapter presents an overview of sexual activity in the Latin American and Caribbean (LAC) region, considering differences by social strata approximated by educational level. Different demographic and health surveys since 2008 and other national surveys have been analyzed, and an extensive review of the literature has been made. Two age groups (25–29 and 45–49) of women and men are compared. The central question to be answered is whether there is a weakening of the traditional link between sexuality and reproduction. We describe trends in early sexual and reproductive events, sexuality during adulthood, contraception and abortion, and gay and bisexual practices. The LAC region has experienced important changes since the beginning of the twenty-first century. These changes include a continuous decrease in fertility with rates below population replacement in several countries, an increase in the duration between sexual debut and transition to first union, an increase in the frequency of sexual relations in the last month among married and never-married women, an increase in the use of modern contraceptive methods, a decrease in sexual violence and an increase in the rights of LGBT+ populations.