To investigate if, when and how assessments regarding residents' sexual health and needs occur within Australian residential aged care facilities.A census of all Australian residential aged care facilities was conducted. A survey developed specifically for the project was posted to all 2766 residential aged care services in Australia. Eight weeks were allowed for the return of surveys.A total of 1094 completed surveys were returned, representing a 39.7% response rate. The type of information most often collected concerned disruptive sexual behaviour, and assessments most frequently occurred following disruptive behaviour. One-quarter of facilities reported having a sexual health/needs assessment form, although only 10 facilities provided evidence of this.Survey responses indicated that sexual health and needs are not routinely assessed in residential aged care, and facilities do not commonly have a dedicated sexual health/needs assessment form to guide them through an assessment process.