The purpose of our study was to examine the role that child sexual abuse may play in body surveillance and sexual risk behaviors among undergraduate women. First, a measured variable path analysis was conducted, which assessed the relations among a history of child sexual abuse, body surveillance, and sexual risk behaviors. Furthermore, body shame, sexual self-efficacy, and alexithymia were examined as intervening variables. Second, a multigroup path analysis was conducted comparing the hypothesized models applied to data from 556 ethnically diverse women. Within the overall model, results revealed that a history of child sexual abuse and body surveillance were not related to one another, but both variables were directly related to sexual risk behaviors. Moreover, body shame mediated the relationship between body surveillance and alexithymia, and alexithymia mediated the relationship between body shame and sexual self-efficacy. Child sexual abuse history was related directly with body shame and alexithymia. Results from the multigroup path analysis revealed that the model was invariant between African American and White women, although one difference emerged: body surveillance significantly predicted alexithymia in White, but not African American, women. Furthermore, White, Asian/Pacific Islander, and Hispanic/Latina women demonstrated more body shame than African American women, and White women endorsed higher levels of sexual self-efficacy than African American and Asian/Pacific Islander women. Counseling interventions that seek to decrease alexithymic symptoms, body surveillance, and body shame, while also increasing sexual self-efficacy, seem especially warranted. (Contains 1 table and 3 figures.)