Background: Previous studies have mainly considered war-affected youth as a homogenous group yet several subpopulations of war-affected youth, such as survivors of sexual violence, exist with unique mental health problems and treatment needs. This study aimed to assess posttraumatic stress disorder (PTSD), perceptions and meaning of mental illness, and access and barriers to mental health care among survivors of sexual violence. Method: Data were collected from survivors of sexual violence during war (N = 181) who are participants in the longitudinal War-Affected Youth Survey (WAYS) study in Northern Uganda. Chi-square tests of independence and binary logistic regression were used to compute participants’ characteristics and assess relations between exposure to sexual violence and PTSD. Results: Sixty-six (n = 119, 66%) reported sexual abuse: 35% (n = 63) of whom returned from captivity with at least 1 child, and 43% (n = 78) met the criteria for PTSD (Impact of Events Scale—Revised score [IES-R] ≥33). Those who reported sexual abuse scored significantly higher on PTSD (OR = 3.23; 95% CI [2.09, 6.93]), perceived more stigma, reported more barriers to seeking care, and viewed mental illness as futile and fatal compared with their peers without a history of sexual abuse. Conclusions: Survivors of sexual violence are at risk of PTSD and report major obstacles to treatment and care. More resources should be allocated for interventions to improve access to care for survivors of sexual violence. Psychoeducation to create awareness, demystify myths and public stigma about mental illness, and trauma-focused cognitive-behavioral therapies to reduce PTSD among survivors are recommended.