Background: Sexual activity during youthful age is common in Lao People’s Democratic Republic. However, youth insufficiently use the sexual and reproductive health (SRH) services and subsequently suffer from poor sexual and reproductive health. To stimulate evidence-informed decision-making in health policies, context specific research describing the barriers preventing Lao youth from accessing sexual and reproductive health services is needed. Objectives: To explore the barriers in access to sexual and reproductive health services among unmarried young people in Laos. Methods: Mixed methods were employed to conduct this study in Xiangkhuang province with 444 youths. Face-to-face interviews using questionnaires classified accessibility as geographical (availability), affordability, and approachability, acceptability, and appropriateness. IDIs and FGDs were used to investigate cognitive, psychosocial, and geographic accessibility, affordability, and SRH service quality. Data were entered into Epi-data 3.1 and exported to STATA 14 for analysis. Univariable and multivariable analysis identified predictors of total accessibility, reported as Adjusted OR with a 95% CI and P-value < 0.05. Results: The results found the mean age of the participants with 19.9 years and 68.6% were female,66.9% of them stayed in urban area, 79.9% were Lao, and 93.5% were single. More than half of the participants had poor level of perception toward accessibility of SRH services (51.4%), and 55.1% encountered barriers, highlighting significant challenges in accessing essential services. In multivariable analysis, spiritual individuals had lower odds in perceiving SRH as accessible than Buddhists (AOR = 0.4, 95%CI: 0.2-0.7, p = 0.004), but no significant difference existed among Christians. Those earning over 1,500,000 LAK were more likely to perceive SRH as accessible than those below this threshold (AOR = 2.7, 95%CI: 1.0-7.0, p = 0.041). Additionally, individuals with sexual experience had higher odds of seeing SRH as accessible compared to unexperienced (AOR = 1.9, 95%CI: 1.2-3.1, p = 0.006). Conclusion: The study on youth's perception and barriers to accessing sexual and reproductive health services revealed unique challenges, including Lao ethnicity and Buddhism, financial obstacles, and family influence. The study suggested that targeted interventions should focus on culturally sensitive service delivery, addressing financial barriers, promoting education, and improving internet access to enhance accessibility and overall well-being among youth populations.