Children who were urgently referred for child sexual abuse evaluations were more likely to be younger and to have had less frequent child protective services (CPS) involvement, more disclosures of abuse, more positive physical examinations, and were more likely to have had contact with older perpetrators than their non-urgently referred counterparts. Most children seen urgently however had normal or non-specific physical examinations. Those children having positive forensic examinations were more likely to be older and to disclose genital contact. The findings indicate that physicians should balance the needs of the child with the need to gather forensic evidence when determining the timing of a medical assessment for child sexual abuse. Data were collected retrospectively from the charts of all patients seen at a community child advocacy center in Grand Rapids, MI for the medical evaluation of child sexual abuse during a 5-year period from 1998 to 2003. The final sample included 190 urgently referred patients and 586 non-urgently referred patients. The SAS software package was used to compare data on the two populations of patients. Future research should continue to probe the remaining questions about which case characteristics should be used to schedule a medical assessment after child sexual abuse. References, figures, tables