Adolescents who communicate with their parents about sexual and reproductive health are more likely to make healthy decisions. This study uses data from a survey conducted in Tabora, Tanzania (N= 1,966 unmarried girls; 425 sexually-experienced). Multivariate logistic regression models are estimated to examine associations between parent-child communication and reproductive health outcomes, controlling for respondent and parent characteristics and socio-demographic factors. Among sexually-experienced girls, communication about HIV/AIDS was associated with greater odds of use of family planning, condom at first sex, consistent condom use and HIV testing. Alternately, communication about sexual relations was associated with lower odds of family planning use, while communication on family planning was associated with earlier initiation of sex. Findings indicate the content of parental sexuality communication is an important consideration for adolescent behavior. Interventions should not only engage parents, but also provide guidance on how to communicate clearly and comprehensively about sexuality, contraceptive use and HIV/AIDS.