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LGBT themes in horror fiction refers to sexuality in horror fiction that can often focus on LGBTQ+ characters and themes within various forms of media. It may deal with characters who are coded as or who are openly LGBTQ+, or it may deal with themes or plots that are specific to gender and sexual minorities. Depending on when it was made, it may contain open statements of gender variance, sexuality, same sex sexual imagery, same sex love or affection or simply a sensibility that has special meaning to LGBTQ+ people.

[[File:Carmilla. jpg|thumb|upright|Illustration by D. H. Friston from the first publication of the lesbian vampire novella Carmilla (1872) by Sheridan Le Fanu and The Picture of Dorian Gray (1890) by Oscar Wilde, which shocked readers with its sensuality and overtly homosexual characters. Jenkins also points out what he sees as gay subtext in Bram Stoker's Dracula (1897), as the titular character wards off other female vampires and claims Jonathan Harker, stating "This man belongs to me!" Talia Schaffer writes in ELH that "Dracula explores Stoker's fear and anxiety as a closeted homosexual man during Oscar Wilde's trial This peculiar tonality of horror derives from Stoker's emotions at this unique moment in gay history." In the following century, the control of the book industry by larger publishers made it difficult to distribute the increasingly overt gay content being produced. Queer horror got a boost with the advent of the pulp novel in the 20th century, a cheap way to manufacture paperback novels that became popularized during World War II. Three on a Broomstick (1967) by Don Holliday is an early example of the gay horror pulp. Richard Dyer discusses the recurring homoerotic motifs of vampire fiction in his article "Children of the Night", primarily "the necessity of secrecy, the persistence of a forbidden passion, and the fear of discovery." With the vampire having been a recurring metaphor for same sex desire from before Stoker's Dracula, Dyer observes that historically earlier representations of vampires tend to evoke horror and later ones turn that horror into celebration. and its publication reinforced the "widely recognized parallel between the queer and the vampire." Professor of English Jolene Zigarovich expands Butler's somewhat binary lens, bringing in Susan Stryker's explicitly transgender analysis of the creature. Stryker likens the creature's construction with the process of medically transitioning, and draws parallels between the subsequent ostracism the creature faced with experience of marginalization experienced by transgender individuals. Zigarovich credits Stryker's work as a catalyst for subsequent queer and trans approaches to Gothic literary analysis, particularly amongst those seeking to reappropriate the maligned imagery of the "unnatural" and variant with regards to gender.

A plethora of more recent horror fiction includes LGBT themes, as the genre's focus on the body, desire, and fear places it in a prime position to tackle issues of normativity and social identity. José Luis Zárate's The Route of Ice and Salt, a groundbreaking 1998 retelling of the voyage of the Demeter in Dracula, brings the subtextual queerness of the novel to the surface by making such themes explicit in his depiction of the ship's captain as gay. Author Billy Martin's horror novels of the 1990's and 2000's are known for featuring gay male characters, as he incorporates his own experiences as a gay trans man into the themes of his work. Emily Danforth's 2020 novel Plain Bad Heroines is a gothic story led entirely by queer female main characters, and references numerous other works of horror fiction. Alison Rumfitt's 2021 debut novel Tell Me I'm Worthless is a gothic twist on the horrors of marginalization, told from the perspective of a trans woman and her transphobic former friend. T. Kingfisher's 2022 novella What Moves The Dead is a retelling of Edgar Allan Poe's The Fall of the House of Usher with a non binary protagonist. Lee Mandelo's 2021 debut novel Summer Sons explores gender identity and queerness in the subgenre of Southern Gothic, as does his 2024 novella The Woods All Black.

The Queer Horror Awards (1998–2007) honored works that involved significant, and generally positive, portrayal of gay, lesbian, bisexual or transgender characters, issues or themes within the area of horror. The Lambda Literary Award includes an award for Science Fiction/Fantasy/Horror. The Gaylactic Spectrum Awards honor works in science fiction, fantasy and horror which include positive explorations of gay, lesbian, bisexual or transgender characters, themes, or issues.