Background: Sex workers (SWs) are globally recognised to be at high risk for the acquisition and transmission of sexually transmissible infections (STIs). There is a paucity of published data concerning SWs from the western suburbs of Sydney, with the last published study conducted in 1988. Therefore, we conducted a study to determine the demographics, sexual practices and health care needs of SWs attending Sexual Health Clinics (SHCs) in the region. Methods: Self-identified SWs presenting to SHCs in western Sydney between April 2007 and March 2008 were identified using clinic databases. A case note review was then undertaken. Results: One hundred and eighty-five female SWs were included in the analysis. Ninety-eight (54.5%) were born overseas (predominantly China) and 82 (45.6%) were born in Australia. One hundred and seventeen (68%) were English speaking backgrounds (ESB), while 55 (32%) were from non-English speaking backgrounds (NESB). Seventy-two (38.9%) were symptomatic on attendance, with vaginal discharge the most common symptom. Chlamydia was the most commonly reported STI in the previous 12 months with 28 cases (15.1%). SWs from NESB were significantly more likely to be older, symptomatic, have a hepatitis B diagnosis in the previous year and work more shifts per week, compared with SWs from ESB. SWs born overseas were more likely to be symptomatic than Australian born SWs who, in turn, were more likely to have a hepatitis C diagnosis in the previous year. Conclusion: SWs from NESB would potentially benefit from evidenced-based, culturally and linguistically appropriate interventions and targeted health promotion.