Most of the literature on sex-appeal advertising focuses on its effectiveness and morality. They were largely based on the individual factors from the microscopic perspective, such as gender of the receivers and the products advertised. A significant research gap exists with regard to the effect of the macroscopic factor, such as institutional context of advertising. Drawing on institutional theory, the present study examines consumers' responses to sex-appeal advertising as a function of two components, regulatory tightness and cultural openness, of institutional change towards modernization. Paradoxically, these two components have opposite effects on consumers' attitudes to sex-appeal advertising. The two opposite effects are expected to have a non-linear relationship with consumers' attitudes to sexual advertising and take the form of an inverted U-shape pattern. In addition, the moderating effects of gender-related factors, including gender of the models shown in the ads and gender of the receivers, are explored. The study adopted a 3 (three cities with varying level of modernization) x 2 (gender of the model) x 2 (gender of the receiver) factorial design. Two-hundred and ten college students were recruited in each city. The hypotheses were generally supported. The study provides empirical support on the inverted U-shape pattern with three cities at different stages of modernization. The findings also shed light on how institutional forces influence consumers' attitudes to sex-appeal advertising. These not only provide practical implications for marketers when considering sex-appeal as advertising execution in different institutional contexts, but also contribute to the academic development in sex-appeal or offensive advertising.