Although sexual assault is one of the fastest growing and most violent crimes in America today, we have much to learn about the best strategies for completing the forensic examination. This integrated review of the literature attempts to shed light on our current knowledge about the pattern and location of genital injuries caused by forced sexual intercourse. Three mechanisms exist for genital examination following sexual assault: direct visualization, staining, and colposcopy. In survivors of sexual assault, reported rates of genital injury vary, with investigators using direct visualization reporting the lowest rates (5%-53%) and investigators using colposcopy technique reporting the highest (68%-87%). In addition, the location of genital injury is important because it may be a mechanism to differentiate consensual from nonconsensual sex. Therefore, as the science develops, the severity, location, and pattern of genital injuries may be used to draw conclusions about the nature and intent of the assault.