This study investigated persistence in abuse-related shame during a 6-year period. One-hundred-eighteen sexually abused youth were interviewed at the time of discovery, and again both 1 and 6 years later. Individuals high in shame 1 year following discovery were especially at risk for persistently high levels of shame 6 years later. Youth with high shame for the abuse at 1 and 6 years were the most likely to report clinically significant levels of intrusive recollections at 6 years. Persistent shame may explain failure to process the abuse and the maintenance of posttraumatic stress disorder symptoms. The findings from this longitudinal study suggest that shame as a consequence of childhood sexual abuse should be a focus of treatment.