Achieving sexual health among adolescents and young people is a major public health concern. Given the scope and severity of the negative consequences associated with initiating sexual activity without adequate preparation, skills, and readiness, the concept of sexual competence warrants closer scholarly attention. This review aimed to describe sexual competence, its key dimensions and consequences, and the role of individual, social, and educational factors in its development among young people. This narrative review was conducted using a systematic search of the Scopus, Web of Science, PubMed, and Embase databases, without time restrictions, up to October 2024. Searches were performed using combinations of the keywords
sexual competence
,
early initiation of sex
,
youth
,
sexual behavior
, and
sex education
, combined with the Boolean operators AND and OR. English-language studies with descriptive, cross-sectional, experimental, interventional, cohort, case–control, or review designs were eligible for inclusion. Studies without full-text availability, conference abstracts, and letters to the editor were excluded. After duplicate removal, titles and abstracts were screened, followed by full-text assessment of potentially relevant articles. Ultimately, 16 studies met the inclusion criteria and were included in the narrative synthesis. The findings were synthesized into four main themes: (1) definitions and dimensions of sexual competence; (2) physical and psychosocial consequences of lacking sexual competence; (3) the role of age, readiness, and contextual factors in achieving sexual competence and preventing adverse sexual outcomes; and (4) the role of education, particularly comprehensive and positive sexuality education, in promoting sexual competence and reducing negative sexual consequences. Sexual competence is a multidimensional construct and a key determinant of sexual health among young people. Strengthening sexual competence through comprehensive, skills-based, and positive sexuality education may enhance the effectiveness of public health strategies aimed at promoting sexual health, equity, and protection in this population.