PURPOSE Clinical trials are important tools for advancing cancer treatment, prevention, and control. To identify and describe clinical effects relevant to underserved groups, their representation in clinical trials is necessary. Lesbian, gay, and bisexual (LGB) people have been identified as a medically underserved group and their representation in cancer clinical trials is unknown. This study sought to examine LGB cancer survivor representation in cancer clinical trials. METHODS Data were from the 2010, Behavioral Risk Factor Surveillance System, Cancer Survivorship Module. Data were from five states that included both the Cancer Survivorship module and an item asking self-identified LGB status. RESULTS Participation in cancer clinical trials was higher among LGB cancer survivors (12.5%) than among heterosexual cancer survivors (6.0%) (p = .005). In the multivariate, adjusted model, LGB cancer survivors were more than twice as likely, as heterosexual cancer survivors, to report participation in a clinical trial (AOR 2.17, 95% CI 1.21-3.90). CONCLUSION LGB cancer survivors had greater likelihood of cancer clinical trial participation than heterosexual cancer survivors and this was not explained by demographics. The finding was unexpected given the historic marginalization of this group. The small number of LGB cancer survivors limits the generalizability and statistical power. Findings should be interpreted cautiously, and further research is needed to clarify explanatory mechanisms.