Objective: To conduct a meta-synthesis of the qualitative research to explore young people's experiences and use of smart phones to send and receive sexually focused messages and images. Design: A qualitative meta-synthesis was conducted on the retrieved papers following a systematic search of PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), COCHRANE, Embase, Medline and Psycinfo. The sample included five qualitative studies with a total sample size of 480 participants. Results: The meta-synthesis of the papers resulted in the development of four central themes: gender inequity, popularity with peers, relationship context, and costs and benefits. Conclusions: Drawing the qualitative work together highlights the manner in which ‘sexting’ is more nuanced than traditional ‘cyber-bullying’. The consensual sending of intimate images is a highly gendered activity. The gender issues require work with female students to explore the issue of ‘sexting’ and how it can be harmful. Work with male students around the issues of respect and gender harassment in relation to ‘sexting’ is also required and should contribute to sex and relationships education. The results indicate that school nurses working with young people need to build discussions about the use of technology within relationships into their work with young people.