Black men who have sex with men (BMSM) represent an increasing, and significant proportion of HIV cases in Toronto. Despite this trend, related research, education and prevention with this population has been notably inadequate and new prevention responses must be considered. The goal of this report is to provide an overview of the significant needs, barriers and service gaps for Black, gay, bisexual and straight-identified African and Caribbean men who have sex with other men in Toronto. It is based upon a consultation process conducted by the Black Coalition for AIDS Prevention’s (Black CAP) MSM HIV Prevention Coordinator with a range of service providers, community researchers and others working in Toronto’s AIDS service sector and African Caribbean communities. The purpose of this report is to guide the creation and implementation of a targeted, Toronto-based HIV prevention initiative for gay, bisexual, and straight-identified BMSM communities.