Like all young people, those living with disabilities have dreams and ambitions, interests and desires, and hopes for their futures. However, discrimination, stigma, and prejudice, together with the failure to incorporate disability into programming, often means that they are left behind in the provision of comprehensive sexuality education (CSE). As a result, they do not receive adequate information about puberty, sexuality, and healthy relationships, making them vulnerable to sexual exploitation and denying them the right to enjoy good quality education and transition safely to adulthood. The overall aim of this needs assessment was to understand the status of delivery of CSE to children and young people with disabilities (CYPWD) in the formal education sector in five focus countries, namely Eswatini, Malawi, Tanzania (including Zanzibar), Zambia, and Zimbabwe.