While existing research documents the impact of parental rejection on sexual minorities, the present study extends this research to include a subtler, yet potentially more pervasive, challenge facing sexual minorities and their parents, with lasting implications for mental health. Parental unfinished business refers to persistent, unresolved negative thoughts and feelings toward one’s parents and is investigated here as a result of parental rejection of their sexual minority sons’ sexual orientation. To capture developmental trajectories of parental unfinished business and its prospective predictors (i.e., rejection) and outcomes (i.e., depressive symptoms, social anxiety, alcohol abuse), young sexual minority men (n = 113; baseline M _age = 20.78) reported their experience of these constructs annually for 7 years. Results revealed significantly decreasing trajectories of unfinished business with mothers, but not fathers, over 7 years. Parental rejection of their son’s sexual orientation prospectively predicted greater next-year unfinished business. Unfinished business with fathers prospectively predicted next-year depressive symptoms. Prospective effects did not extend to next-year social anxiety or alcohol abuse for unfinished business with either parent. This study positions unfinished business as a novel, distinct, and important component of young sexual minority men’s identity development and depression and examines these constructs over seven formative years. Findings can inform theoretical accounts of sexual minority development and clinical case formulation. (PsycINFO Database Record (c) 2018 APA, all rights reserved)