In 2001, FPA Health, whose primary goal is to improve access to a range of reproductive and sexual health services for regional, rural and remote areas in New South Wales, conducted a reproductive and sexual health needs assessment of the Macquarie area. Community consultations were conducted with students, adolescent mothers, men, middle aged women in isolated communities, Indigenous men and women and local service providers. The areas that were identified as requiring attention were education for young people around sex, pregnancy and sexually transmissible infections, education for men and services, and education for Indigenous people in reproductive and sexual health. The author discusses the methodologies and outcomes of the various projects that resulted.