A diverse sample of community-residing women in a large metropolitan area who had experienced adult sexual assault was surveyed using standardized measures in an NIAAA-funded study (2003-2004). Four groups (N = 503) of victims: (1) post-traumatic stress disorder (PTSD)-only, (2) PTSD and illicit drug use, (3) PTSD and drinking problems, and (4) PTSD and polysubstance use were compared using bivariate analyses. Victims with PTSD/polysubstance use had lower socioeconomic status, more extensive trauma histories, worse current psychological functioning, more problematic post-assault psychosocial experiences, and more sexual revictimization at follow-up than those with PTSD only. Implications for future research are discussed.