This study investigates prospective associations between body satisfaction and condom use among adolescent girls and examines whether these associations are moderated by ethnicity or early initiation of sexual activity. Adolescent girls (n = 182), recruited from public schools in the Northeastern USA, completed surveys in the 8th, 10th, and 12th grade. Hierarchical logistic regression was used to predict condom use practices in 12th grade. Eighth grade body satisfaction predicted consistent condom use in 12th grade, but this finding did not generalize to girls who first had sexual intercourse prior to 10th grade. Findings suggest that body satisfaction may be an important contributor to adolescent sexual health. Moreover, results identify a psychosocial risk factor for inconsistent condom use that can be identified prior to the onset of risky sexual behavior and improved via intervention.