All adults who interact with preschool children need to be aware of possible indicators of sexual abuse. This information is especially important to advanced practice psychiatric/mental health nurses who interact with preschool-aged children in clinical, therapeutic, educational, research, legal, and community settings and to other nurses working in pediatric settings. Because there are few, if any, absolute physical indicators of child sexual abuse, the identification of empirically based emotional and behavioral indicators is important. This article reviews six studies that sought to identify such indicators for the preschool population. Studies reviewed confirm that not all sexually abused children are equally traumatized. When sexually abused children were compared to groups of non-sexually abused children receiving psychiatric services only one discriminating variable consistently arose. When overt sexual behavior, inappropriate for age, is manifested by a preschool-aged child, sexual abuse should be suspected. The identification of manifestations of sexual abuse in preschool-aged children is an appropriate topic for nursing research.