BACKGROUND:Studies of the relationship between cortisol and posttraumatic stress disorder (PTSD) have had inconsistent results. Gender, trauma type, and age at trauma exposure may explain the inconsistencies. OBJECTIVE: The objective of the review was to examine cortisol levels in relation to PTSD in women with a history of child maltreatment trauma. DESIGN: A review of literature found 13 articles eligible for inclusion. RESULTS: Despite limiting focus to the relatively homogeneous population, the patterns of associations between PTSD and cortisol levels were still inconsistent. CONCLUSIONS: The reasons for the inconsistencies likely include highly varied methods across studies, small convenience samples, and unmeasured neuroendocrine hormones that may be stronger predictors of PTSD. The review does not point to a clear bio-behavioral target for psychiatric nursing intervention. It is important to continue to address the developmental and clinical stress response aspects of child maltreatment trauma–related PTSD without assuming that these stress responses are hypothalamic-pituitary-adrenal–axis driven.