This study was undertaken to describe the knowledge about child sexual abuse, and factors that affect the knowledge of a statewide sample of physicians. A survey of physicians (n = 113) participating in a statewide program for child abuse evaluations was made in Summer 1993, with 78% participation. Knowledge scores were derived from the survey based on comparison to the responses of a panel of five experts. Several areas of inadequate knowledge were found including assessment of chlamydia infection, Tanner staging, and documentation of historical and physical exam findings. Factors associated with better knowledge scores were physician participation in continuing medical education and specialization in pediatrics. In addition, variations in presentation of the data affected physician judgement. We conclude that knowledge of physicians about child sexual abuse shows some deficiencies, is generally better among pediatricians, and may be improved by continuing medical education.