Transactional sex refers to the exchange of sex for material or financial gains or benefits. Much of the existing literature suggests that women engage in sex for material and financial gain in an effort to mitigate the impact of food insecurity – so-called survival sex. In contrast, this literature review finds transactional sex occurs in diverse contexts, is motivated by various factors and is influenced by gendered socio-economic and cultural factors. The paper examines the motivations behind women’s engagement in different types of transactional sex; the role of violence in transactional sex, and asks what degree of agency do women have within the practice and are they able to negotiate for safe sex.