BackgroundAdolescent sexual violence victimization is a significant public health issue in the United States. Structural sexism, a form of gender inequality at the societal level, may play a crucial role in influencing the prevalence of sexual violence victimization among adolescents. ObjectiveThis study aims to examine the association between state-level structural sexism and sexual violence victimization among adolescents and to explore how this relationship varies between male and female adolescents. Participants and settingData was derived from a nationally representative sample of high school students in grades 9–12 across the United States who participated in the Youth Risk Behavior Surveillance System (YRBS) in 2017 and 2019. MethodsA state-level structural sexism index was created from nine different items to reflect the multidimensional nature of structural sexism. This study employs multi-level regression analysis to investigate the impact of state-level structural sexism on three types of sexual violence victimization: sexual violence, sexual dating violence, and physical dating violence. ResultsThis study revealed a significant interaction between structural sexism and gender. In states with higher levels of structural sexism, female adolescents reported increased likelihood of sexual violence (β = 0.013, p < .001), sexual dating violence (β = 0.006, p < .001), and physical dating violence (β = 0.006, p < .001) compared to males. Conversely, male adolescents in these states reported lower rates of victimization. ConclusionsThe results underscore the role of structural sexism in influencing sexual violence victimization among adolescents. Addressing structural sexism may be essential in mitigating the risk of sexual violence victimization, especially for female adolescents.