• The dramatic increase in the incidence of reports of sexual abuse has placed demands on physicians to assess children for possible sexual abuse. We conducted a survey of urban pediatricians to determine their knowledge of and attitudes about sexual abuse. These physicians were found to have limited knowledge about the social and medical aspects of sexual abuse. The lack of knowledge these physicians display about prepubescent female anatomy and about the association of venereal diseases with sexual abuse decreases their recognition and reporting of sexual abuse. There is a need for physicians to improve their knowledge and skills in the diagnosis of sexual abuse if further abuse and its serious consequences are to be minimized.