The case records of 311 children and adolescents who were medically evaluated for sexual abuse are reviewed. Only 18% of these victims were assaulted by strangers; 131 of the assailants were relatives. Thirty percent of the victims reported multiple assaults over a time period of one week to nine years. Physical examination showed no abnormalities in only 23% of the patients. Twenty-one patients had gonorrhea and seven patients were pregnant. Guidelines for the medical evaluation of patients suspected to be victims of sexual abuse are discussed.