In Cameroon, HIV prevalence among youths (15-24 years) is 2% and 26.5% of them have unwanted pregnancies. Sexual and reproductive health (SRH) services are widely available, whose optimal utilization will reduce these high rates of HIV/STI transmission and pregnancies, but their knowledge and uptake of these services are unknown. This study aimed to assess determinants of SRH knowledge and uptake among HIV-infected youths in the Northwest region of Cameroon. This cross-sectional study received administrative authorization from the Delegation of Northwest and CBCHB IRB approval (IRB2021-77). We sequentially sampled youths living with HIV and receiving care at 16 treatment sites. Data was anonymously collected from consented participants between February and April 2022 using a structured questionnaire. The data was analysed using Stata version 14.0. In total 340 participants were enrolled, 70% female, 62% within 15-19 age group. Overall, knowledge of participants on SHR services was 78% and its uptake was 58%. Knowledge was 71% for SRH counselling, 78% for pregnancy prevention, 78% for STIs services and uptake of these services was 78%, 70% and 76% respectively. Increased age positively predicted SRH knowledge while urban residence had a negative influence. Being a male, living in urban residence and not schooling was negatively associated with SRH service uptake while good SRH knowledge positively predicted uptake. The suboptimal level of knowledge, consistent with low service uptake suggests the need for more sensitization and education on SHR services which is key to influencing uptake of these services and consequently reducing unintended pregnancies and HIV/STIs transmission. Keywords: Sexual and reproductive health, knowledge, uptake.