Acute sexual assault includes a broad spectrum of nonconsensual sexual activity. Care of victims of acute sexual assault can be challenging, especially given the significant potential psychological and legal ramifications of the event and subsequent medical care and forensic evidence collection. In some emergency department settings, utilization of sexual assault response teams and sexual assault nurse examiners has demonstrated that a systematic approach to these patients improves care. However, given that victims of acute sexual assault are likely to present for care in emergency departments where such teams do not exist, it is critical for the emergency medicine physician, pediatrician, and family physician to have knowledge of key aspects of history taking, the physical examination, evidence collection, and medical record documentation. This review of care of the victim of acute sexual assault will provide practitioners with the tools needed to effectively evaluate these patients.