Emtricitabine/tenofovir disoproxil fumarate as pre-exposure prophylaxis (PrEP) can prevent HIV infection among at-risk individuals, including young transgender women (YTW). We used baseline data from 230 HIV-uninfected YTW (ages 16-29 years) who were enrolled in Project LifeSkills during 2012-2015. We examined factors associated with perceived acceptability of PrEP use (mean score = 23.4, range 10.0-30.0). Participants were largely transgender women of color (67%) and had a mean age of 23 years (SD = 3.5). In an adjusted multiple linear regression model, PrEP interest (beta = 3.7, 95% CI 2.2-5.2) and having a medical provider who meets their health needs (beta = 2.9, 95% CI 1.3-4.4) was associated with higher PrEP acceptability scores, whereas younger age (21-25 vs 26-29 years) (beta = -2.0, 95% CI - 3.6 to - 0.4) and reporting transactional sex in the past 4 months (beta = - 1.5, 95% CI - 3.0 to - 0.1) was associated with lower PrEP acceptability scores (all p values < 0.05). Enhancing PrEP-related interventions by addressing the unique barriers to uptake among YTW of younger age or those with history of transactional sex could bolster PrEP acceptability for this population.