During the past decade, increased research attention has brought female sexual function to the forefront as one of the side effects of cancer. A similar level of information is needed for a subpopulation of women, that is, sexual minority women with cancer. To make the needed information available, we review the literature regarding sexual functioning in SMW after cancer and explore reasons why it may differ from that of heterosexual women. Sparse, available data suggest that there are some similarities and differences between sexual minority and heterosexual women with cancer. There are tentative suggestions that sexual minority women may enjoy less disruption in their sexual relationship, fewer sexual problems such as lubrication, achieving orgasm, better body image, and more understanding and supportive partners compared with heterosexual women. Areas of greater vulnerability and risk for sexual minority women survivors compared with heterosexual survivors are some maladaptive coping and problems obtaining information and support from medical professionals with respect to sexual functioning. Sexual functioning may be worse among subgroups of sexual minority women. We identify critical areas that merit further clinical and research attention and point to methodological challenges for future research on sexual functioning in sexual minority women.