Antimicrobial resistance (AMR) among sexually transmitted infections (STI) is a global concern, and is epitomised by the fact we are now running out of treatment options for Neisseria gonorrhoeae and Mycoplasma genitalium infections. The role of AMR surveillance is now more important than ever. Ideally, AMR surveillance tools should be fast, inexpensive, accessible, and provide clinically meaningful information to inform treatment strategies. In reality this has not been the case for many STI pathogens, with STI AMR surveillance activities typically weak or non-existent in many parts of the world. Molecular methods have the potential to enhance AMR surveillance, particularly for organisms that cannot easily or readily be characterised by traditional bacterial cultured based methods, and is highlighted by the recent Gonorrhoea Resistance Assessment via Nucleic Acid Detection (GRAND) studies being conducted here in Australia. New molecular AMR methods for STIs, including commercial systems, are being developed and now finding their way into routine settings. Advances in molecular technology, expanding knowledge of resistance mechanisms, and new databases help to pave new directions in this important area.