Concerns relating to the methodological rigour of studies examining the frequency and effects of childhood sexual abuse (CSA) have comforted those who dismiss the results as scaremongering. This review highlights the difficulties to be overcome in interpreting the epidemiological data currently available, and the lack of consensus regarding the true frequency of CSA and the impact such abuse has on the lives of adult survivors. However, it concludes that the rates of reporting and disclosing a history of CSA are increasing, and that the health service needs to recognise and respond to this changing clinical picture.