First sexual intercourse is an important experience in the young adult life course. While previous research has examined racial, gender, and socioeconomic differences in the characteristics of first sexual intercourse, less is known about differences by disability status. Using a racially diverse (27% Black, 20% Hispanic, and 53% non-Hispanic white) sample of 2,729 adolescent girls aged 12–24 at first sexual intercourse from the National Longitudinal Survey of Youth 1997, this article examines the association between disability and type of first sexual relationship, degree of discussion about birth control, and pregnancy wantedness. Regression analyses indicate that girls with mild or learning or emotional disabilities experience first sexual intercourse in different types of relationships than girls without disabilities. Adolescents with learning or emotional conditions have greater levels of discussion about birth control with their first sexual partners than those without disabilities. In addition, among those who do not use birth control at first sexual intercourse, girls with multiple or seriously limiting conditions are more likely to want a pregnancy—versus not want a pregnancy—at first sexual intercourse. Findings indicate that disability status is important to consider when examining adolescent sexuality; however, not all youth with disabilities have equal experiences.