Objectives: To identify differences in health-related quality of life among women veterans who were raped, physically assaulted (not in the context of rape or domestic violence), both, or neither during military service.Methods: We did a cross-sectional telephone survey of a national sample of 558 women veterans who served in Vietnam and subsequent eras of military service. A stratified survey design selected subjects according to era of service and location. The interview included socioeconomic information, lifetime violence history, the Women's Military Environment Survey to assess women's military experiences, and the Medical Outcomes Study Short Form-36 to assess health-related quality of life.Results: Five hundred thirty-seven women completed the interview. Half (48%) experienced violence during military service, including rape (30%), physical assault (35%), or both (16%). Women who were raped or dually victimized were more likely to report chronic health problems, prescription medication use for emotional problems, failure to complete college, and annual incomes less than $25,000 (P < < < .05). Women who were physically assaulted or raped reported significantly lower health-related quality of life (P < < < .05). Those who had both traumas reported the most severe impairment, comparable to women with chronic illnesses.Conclusion: This study suggests that the sequelae of violence against women are an important public health concern. More than a decade after rape or physical assault during military service, women reported severely Violence against American women is surprisingly frequent. Estimates are that one in five women are raped by 21 years of age. 1 Although the incidence of first rape peaks in young women 12 to 17 years old, 2 more than 60,000 rapes of women over age 50 are reported annually. 3 Violence has been identified as a widespread occupational risk for women. Nonfatal assaults account for 42% of women's workplace injuries. 4 More women die from workplace violence than from job-related accidents. 5 Furthermore, the risk of workplace violence appears heightened in some occupations, such as military service. 6,7 Violence recently has gained attention as a women's health issue that has been neglected. 8 Clinical research has focused on the psychologic effects of sexual victimization with limited recognition of the health-related consequences. However, a growing body of literature indicates that sexual violence can have life-long medical repercussions. 9 World Bank economists estimated that sexual victimization accounts for almost 1 in every 5 health-years of life lost among young women (age 15-44 years). 10 One half of rape victims sustain vaginal or perineal trauma. 11 Fifteen percent of victims have significant vaginal tears and 1% require surgical repair of lacerations. 11 Thirty-nine percent of rape victims sustain nongenital injuries, over half of which require medical attention. 11,12 Sexually transmitted diseases (STDs) occur in up to 43% of victims. 13 Rape is associated with increased symp...