Child sexual abuse is being recognized as a common and serious problem which affects children regardless of their age, sex, socio-economic class, or geographic location. Children of all ages, from infancy to young adulthood, have been victims of abuse. It is well accepted that the number of reported incidents of child sexual abuse represents only a portion of the actual number of victims. The National Center on Child Abuse and Neglect estimates the number of child-victims to be more than 200000 per year. Many of these children are brought to emergency facilities or to their private physician's office for evaluation. Many physicians have difficulties in correctly identifying and managing child-victims of sexual abuse. The purpose of this chapter is to review the most recent advances in the medical evaluation of children who are the victims of sexual abuse.