The purposes of this study were to explore the sexual knowledge, attitudes, behaviors and needs for sexuality education of the upper graders in the elementary schools in Taiwan, to compare the differences among the above variables based on some demographic variables, and furthermore, to identify the potential predictors of students’ needs for sexuality education. The study also focused on the parents of these students. It explored parent-child communication about sex issues, parents’ perceived efficacy of giving sexuality education at home, and their opinions of having sexuality education in families, schools, and the society. To make the sample representative, stratified cluster sampling was used to select subjects from 36 elementary schools, which were randomly selected from eastern, western, northern, and southern parts of Taiwan in proportion to their population allocation. Thus the subjects included 1867 students and 1698 students’ parents. The main findings of this study were as follows: 1. Students’ sexual knowledge was insufficient, sexual attitudes tended to be positive, and their age of puberty was earlier. A few of them had experienced dating and masturbation. 2. Students’ main sources of the sexual knowledge were teachers, mother, textbooks, father, and peers. Their perceived demands for sexual education were “Sexual Health”, “Relationships”, and “Society and Culture”. 3. Students’ sexual knowledge, attitudes, and needs for sexuality education indicated significant differences due to their genders, levels, grades, resident areas, and the amount of sexual information they abtained. 4. Students’ sex knowledge, attitudes and behaviors could significantly predict their demands for sexuality education, explaining 24% variation. Further discussions were made on the basis of present research findings and some suggestions were proposed.