This study seeks to understand the effects of the co-occurrence of PTSD and problem drinking on formal help-seeking among sexual assault survivors over time. Data come from a diverse sample of 1,863 women in a large Midwestern city who participated in a 3-year study on women’s experiences with sexual assault. Generalized Estimating Equations (GEE) were used to estimate the parameters of generalized linear models to assess the effects of PTSD and problem drinking on survivor mental health help-seeking and substance use treatment-seeking over time. In our models, having more PTSD, more education, and receiving a reaction of tangible support increased the odds of survivors seeking mental health treatment, which replicates past findings. This is the first study of women sexual assault survivors to find a unique effect of both PTSD and problem drinking on substance use treatment-seeking. The findings suggest survivors with co-occurring PTSD and problem drinking are less likely to seek substance use treatment over time. Future directions are discussed for research on survivors with co-occurring symptoms.