In 2006, the Food and Drug Administration (FDA) approved access to emergency contraception through pharmacies without a prescription. Several states, however, had previously allowed pharmacy access to emergency contraception. In particular, Washington State was the first state to implement such a program in 1998. If emergency contraception is used as a substitute for a surgical abortion, then pharmacy access could reduce unintended pregnancy. Pharmacy access, however, could lead to an increase in risk taking, especially among teens or young adults, and hence lead to increased rates of sexually transmitted diseases. In this article, we use county‐level data as well as specific timing of changes in pharmacy access to consider the intended and unintended consequences of pharmacy access to emergency contraception in Washington. The results indicate that while county‐level access to emergency contraception was unrelated to trends in sexually transmitted diseases (STDs) and abortions before access changed, access afterwards led to a statistically significant increase in STD rates (gonorrhea rates), both overall and for females. We do not find, however, an impact of pharmacy access on abortion or birth rates. These results are robust to several specification tests (including use of Oregon counties as additional control counties) as well as several falsification tests. (JEL I1, I18, J13)