Community mobilization around gay rights in the late 1960s and 1970s led to the first efforts to improve the health of gay and bisexual men. In the 1980s the deadly AIDS epidemic was responded to with fierce organizing and community activism, primarily led by gay men. Today, community involvement is crucial to many advocacy and organizing efforts for the health of gay and bisexual men. This article begins with the roots of this history and then describes how they are reflected in a number of key health initiatives for this community including the National Black Gay Men’s Advocacy Coalition, the Legacy Project, International Rectal Microbicide Advocates and the Gay Men’s Health Agenda. A path forward is described in terms of next steps for advocacy for gay men’s health and the health of gay and bisexual men of color emphasizing cultural viability, development of new leaders, and strategic alliances.