This report presents a working definition of child sexual abuse based on the Federal statute and State child abuse laws. Various circumstances are presented to enable the health professional to determine if a child has been sexually abused. Once this determination has been made or if child abuse is suspected, reports must be made in a timely fashion to the proper child protection service or police agency. The health professional must also notify the child's parent or guardian of the action taken. Methods are suggested to obtain the required historical assessment and physical examination, and the civil and criminal processes that pertain to child sexual abuse are explained. An appendix lists the names of surgeons and Federal government personnel who contributed to the publication as well as relevant publications.