The authors conducted a meta-analytic review of the relationship between a history of child sexual abuse (CSA) and psychological problems in adult women in 38 studies meeting rigorous research criteria. Across all symptoms, a significant association was found between history of CSA and adult symptomatology. Analysis of the role of moderating variables indicated the associations were stronger among subjects recruited from clinical populations. When individual symptom domains were examined, anxiety, anger, depression, revictimization, self-mutilation, sexual problems, substance abuse, suicidality, impairment of self-concept, interpersonal problems, obsessions and compulsions, dissociation, posttraumatic stress responses, and somatization all yielded significant associations with sexual abuse. These results are discussed in light of their relevance to research methodology and clinical intervention.