This study examined the relative influence of early sexual debut (ESD) and pubertal timing on psychological distress from adolescence to young adulthood in Taiwan, a non-Western society with a distinct cultural and family context. Data were from a cohort sample of 15-year-olds (N = 2595) first interviewed in 2000, with four follow-ups during a 7-year period. Psychological distress was assessed by a reduced form of the Symptom Checklist-90 Revised. ESD was defined by first intercourse at age 15 or younger. Multivariate analyses via growth curve modeling found a greater increase in psychological distress over time in adolescents with ESD (β = .28, p < .05). Early-pubertal adolescents were at greater risk for the onset of psychological distress (β = .46, p < .05). Further, early pubertal adolescents with an ESD appeared to be especially likely to be distressed (β = 3.39, p < .05). In addition, analyses showed a non-linear trajectory of psychological distress between the ages of 15 and 22, with distress escalating (β = .45, p < .001) as age increased before tapering off as adolescents became young adults (β = -.03, p < .001). Results suggest the contributing influence of both ESD and pubertal timing on distress trajectories, independent of parental and family characteristics.