This scoping review aims to synthesize existing literature on good practice in sexual health interventions for adults over 45 years and in vulnerable groups. Methods Using PRISMA-ScR guidelines, search terms focused on sexual health, good practice, and vulnerable groups, in over-45s. Results Of the 9 studies that met the inclusion criteria, 7 were focused on HIV and risk reduction. Use of alternative methods of communication, alongside inclusion of behavioral and cognitive measures such as condom use and perceived stigma, was key to tailoring interventions. Conclusion This review highlights the imperative for further research on sexual health interventions with these overlooked populations.