To study the attendance rates and characteristics of sexual violence presented at emergency services for rape victims, over a 10-year period. Design. Incidence study. Setting. Rape Trauma Service, within an emergency department at a tertiary referral university hospital. Population. The total female population in Iceland. Methods. Medical records on visits were reviewed and systematically coded. Annual attendance rates were calculated over time as number of visits per 10 000 female inhabitants aged 13–49 years. Characteristics of sexual violence, perpetrators and victims were compared between 1998–2002 and 2003–2007. Main outcome measures. Annual attendance rates and characteristics of sexual violence. Results. Of 1153 visits, 828 (71.8%) were due to severe sexual violence (penetration). Annual attendance rates of all sexual violence increased from 12.5 to 16.9 per 10 000 women aged 13–49 (p<0.01). Attendance rates due to severe sexual violence increased specifically among women aged 18–25 (p<0.01). The proportion of assaults involving multiple perpetrators increased from 13.9% in 1998–2002 to 18.9% in 2003–2007 (p=0.05). With time, a higher proportion of victims had seriously impaired consciousness due to alcohol consumption (p<0.01) and had used illegal drugs prior to assault (p<0.05). Conclusions. The findings point towards an increase in women's visits to specialized emergency services for rape victims, particularly in the age group 18–25 years. The increased role of multiple perpetrators, alcohol and illicit drugs in sexual violence calls for further attention.