In South Africa, females under the age of 18 comprise approximately 40% of the rapes and other forms of sexual assault that occur. However, South African girls face multiple barriers to seeking help in the aftermath of sexual assault. This literature review provides an overview of childhood sexual assault in South African girls and addresses barriers to help-seeking behaviors. Risk factors as well as relevant sociocultural, economic, structural, and psychological perceptions regarding childhood sexual assault among South African girls are also discussed. Finally, clinical implications, culturally relevant psychotherapeutic techniques, and suggestions for future research are provided in an effort to reduce the negative mental health consequences for the victims.