The COVID-19 pandemic is exposing and exacerbating pervasive obstacles to sexual health, family planning, prenatal, labor and delivery, postpartum, and abortion care in the U.S. It is also illuminating how overlapping systems of oppression unjustly mar the health and wellbeing of people with disabilities, LGBTQ individuals, and people of color, including Black, Latinx, Asian American, Indigenous/Tribal, and undocumented immigrant communities. Some efforts to halt the spread of COVID-19 and facilitate treatment have inadvertently disrupted and diverted resources away from essential and urgently needed reproductive and sexual health services. Anti-choice policymakers have also exploited the crisis, building on existing systemic barriers to further restrict and effectively ban access. Together, these challenges undermine reproductive and sexual health, rights, and justice, especially for marginalized communities. These injustices produce and compound gaps in and hurdles to crucial and time-sensitive health services. Fortunately, states have numerous opportunities to ensure all individuals can access comprehensive and quality reproductive and sexual health care during and after the pandemic.