Objective To describe demographic and assault-related characteristics of children attending an acute sexual assault referral centre in London within a week of alleged sexual assault.

Design Retrospective case note review of all children aged 12 years and under who reported between 1 January 2008 and 31 December 2013.

Main outcome measures Age, sex, ethnicity, drugs and alcohol around the time of assault, nature of offence, relationship with perpetrator, additional violence, verbal threats, presence of injury.

Results 176 children attended; 80% were female. Perpetrators were known casually to the victim in almost half of cases (49%) and familial assault was reported in 55 cases (31%). 43% of boys and 28% of girls reported that the perpetrator was under the age of 16 years. Familial domestic violence was reported by 17%, and more boys (26%) than girls (14%) were reported to have a learning difficulty. Extragenital injury was found in 14% and anogenital injury in 17%.

Conclusions This study provides an important overview of young children referred for forensic medical examination in the week following an allegation of sexual assault. Rates of learning difficulty and domestic violence were relatively high, and alcohol and drug use was rare. A large number of alleged perpetrators were young themselves. Additional violence was not common, and rates of injury were low. There may be important differences in sexual offences against boys and girls. Further research is necessary, as is greater case identification and referral for services.