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Purpose: The purpose of this study was to identify the relationship between self-esteem and sexual attitude in healthcare college students, and also to provide a basis for sexual health education programs to help establish healthy sexual attitudes. Methods: A survey was conducted with 218 unmarried students attending the healthcare colleges in B and U cities. Data were collected from October 15 to November 10, 2015 and analyzed using Stepwise multiple regression with SPSS PASW 18.0. Results: Mean score for self-esteem was 3.23±0.46 out of 5 and sexual attitude 2.64 ± 0.54 out of 5. Self-esteem and sexual attitude had a negative correlation (r = -.169, p = .012). Among sub-variables of sexual attitude, negative correlations were found between self-esteem and premarital chastity (r = -.207, p = .002), and between self-esteem and homosexual attitudes (r = -.167, p = .013). There were statistically significant differences in sexual attitude according to perceived intimacy with mother (β = -.228, p < .001), year in college (β = .135, p = .047), major (β = .148, p = .023), religion (β = -2.429, p = .016), and homosexual tendencies (β = .139, p = .037). These factors explained 14.6% of the variance in sexual attitude. Conclusion: Findings demonstrate the importance of self-esteem for sexual attitudes. This finding should be used in the development of healthcare college students, promotion programs to enhance healthy sexual attitudes.