In remote and very remote Australia, young people engage youth workers in sexual health discussions, often out of necessity due to low access to health services. Youth workers’ and youth service managers’ perspectives on these interactions and the sexual health training they receive are poorly understood. In this study, youth workers and youth service managers working in the Pilbara, a remote region in Western Australia, participated in semi-structured online video interviews. Participants (n = 10) were asked about their experiences and the impact of sexual health training on their work. Data were thematically analysed. Four themes were developed: Pilbara youth workers and youth service managers need sexual health training; locally delivered sexual health training is preferable; online sexual health training may augment knowledge; and strategies to optimise sexual health training are needed. The results of this study suggest current training is not meeting the needs of youth workers and youth service managers in the Pilbara, and they feel under equipped to address sexual health topics with young people. Suggestions are made to improve youth workers’ and youth service managers’ access to effective sexual health training.