The COVID-19 public health crisis is having rapid and profound effects on how people around the world are living their lives. Adolescents and young adults (AYA) aged 12–24 in the United States are at low risk for hospitalization and death from COVID-19 compared with other age-groups. However, the disease may affect other aspects of their physical, mental and social health. Sexual and reproductive health (SRH) touches upon all of these domains, and involves intimate relationships, sexual activity, contraceptive use and abortion care. Evidence of the SRH impacts of previous large-scale disruptions in the United States, including natural disasters and the 2008 recession, suggests that the current pandemic will have serious and sustained effects on young people. AYA will experience the current pandemic in ways that reflect their unique developmental and cohort situations. In this viewpoint, we review potential immediate and longer term impacts of the COVID-19 pandemic on the SRH needs and behaviors of AYA, and provide direct evidence of COVID-19 impacts where available.