There is little literature on childhood sexual abuse in women seen by forensic services. A cohort of 225 cases of women seen by forensic services in a medium secure unit in the UK were examined, and childhood sexual abuse and non-childhood sexual abuse cases were compared. Over half the sample had a history of childhood sexual abuse, and 5.6% of this group were victims of a subsequent sexual assault in adulthood. The perpetrators were all male. The majority of intrafamilial cases resulted in victims being raised in environments outside the family home. Childhood sexual abuse was associated with later relationship, educational, and occupational difficulties. Significant associations were also seen with personality disorder, self-harm, and substance misuse. Treating services need to recognize the potential importance of childhood sexual abuse in their models of care given the complexity of the association between childhood sexual abuse and psychosocial needs and its impact on successful rehabilitation. (Contains 2 tables.)