The purpose of this paper is to explore the context of the sexual health of Latino migrant day labourers in the USA, challenges to sexual health and ways of coping, with attention to conditions of structural vulnerability permeating the lives of this unique Latino population. Given the limited information about this topic and population, ethnographic research employing in-depth semi-structured interviews with 51 labourers, recruited through purposive sampling in the San Francisco Bay Area, was utilised. The sexual health aspirations of the men are deeply embedded in the core value and practice of Latino familismo or, in this case, the central goal of securing a family headed by men as providers and present husbands/fathers. However, such goals are frequently thwarted by the poverty engendering work and prolonged separations from home that characterise predominantly undocumented day labour in the USA. Resulting goal frustration, combined with pent up sexual urges, often lead to sexual risk in spite of efforts to cope with challenges to sexual health. Unless community-, state- and national-level interventions are developed to mitigate the pronounced structural vulnerability of migrant day labourers, individual level interventions to promote sexual health, and decrease risk and distress, are likely to have diminishing returns.