Background. Despite the high prevalence, few studies have examined pornography consumption among emerging adults in Malaysia. The current study examined the attitudes, motivations, and behaviours related to pornography consumption and their association with sexual health. Methods. Using a cross-sectional survey that was conducted online, a convenience sample of 319 Malaysians aged 18-30 years (M = 23.05, s.d. = 2.55) reported their attitudes and behaviours related to pornography consumption, including the degree of problematic consumption, and completed measures of sexual health. These included sexual satisfaction, awareness of sexual feelings, sexual self-reflection, sexual assertiveness, embarrassment during partnered sex, and genital image. To capture pornography genre preferences, participants also reported the keywords that they typically use to search for pornography. These open-ended responses were thematically coded. Results. Between 60 and 70% of participants reported positive attitudes toward pornography and 81.2% (N = 259) reported lifetime intentional exposure to pornography. Gender differences were present in pornography consumption attitudes, motivations, preferences, and behaviours. Problematic pornography consumption, and not consumption frequency, was associated with poorer sexual satisfaction. Among women and not men, more frequent consumption was associated with more sexual self-reflection and positive feelings about their genitals. Sexual embarrassment was higher among women who consume pornography more problematically and among men who consumed pornography more frequently. Conclusions. Pornography consumption attitudes and behaviours appear rather universal. However, the benefits of pornography consumption frequency and disadvantages associated with problematic consumption appear to be more relevant for women's than men's sexual health, specifically sexual self-reflection, genital image, and sexual embarrassment.