Abstract Purpose To investigate how exposure to sex, alcohol and violent content in mainstream and Black-oriented movies relates to corresponding adolescent behavior among Black youth from the United States and whether those relationships are moderated by ethnic identity. Methods The present study uses survey data from an online sample of 1000 Black adolescents and content analysis ratings on top-grossing 2014 films and 2013/2014 Black-oriented films. Content-specific exposure measures for alcohol, sexual activity, and violence were calculated from self-reported exposure data and content analysis ratings. Regression analyses estimated the associations among exposures to risky health content in mainstream and Black-oriented films and adolescent behaviors as well as moderation by ethnic group identity. Results Black adolescents were mostly unaffected by exposure to risk portrayals in mainstream films, but exposure to risk in Black-oriented films was related to their behavior in all three domains. Strong group identity strengthened the relationship between exposure to sex in Black-oriented and mainstream films depending on the sexual outcome. Conclusion The type of movie (i.e., mainstream or Black-oriented) through which Black adolescents are exposed to risky health portrayals is important for understanding its relationship to their behavior, and variations by ethnic identity were limited to sex content. Future research should identify the mechanisms through which risk content in Black-oriented films is associated with Black adolescents’ risky behaviors to determine how media influence contributes to behavioral disparities among youth.