Consistent with previous research, this study identified genital injuries following both consensual and nonconsensual intercourse. Ecchymosis was more commonly found following nonconsensual intercourse. This consists of the oozing of blood from a blood vessel into tissues as the result of contusions or disease. Ecchymosis may not be clearly visible if initial genital exams are performed immediately after the assault. In clinical practice, it may be necessary to conduct a re-examination of the genital area to allow for clearer evidence of ecchymosis. In the current study, the mean time to exam for the nonconsensual group was 12.9 hours; whereas, the examination of the consensual group was limited to the first 24 hours, with a mean time of 12.1 hours. Future studies should match these times in order to avoid missing genital findings due to delayed presentation or wound healing. Although the study found no statistical difference in the frequency of injuries to the posterior fourchette between the groups, there was a statistically significant group difference in the injuries to the labia minora; these injuries occurred only in the nonconsensual group. Also, there were significantly more women in the nonconsensual group with two or more injuries. Such findings indicate that there may be a possible pattern of injuries that can be identified following nonconsensual intercourse. Further research is needed. The study documented injuries with the colposcope in combination with dye enhancement and photography. The nonconsensual group consisted of women who came to the emergency department of a Virginia hospital following a reported sexual assault. Consensual women were recruited through advertisements. 3 tables and 38 references