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Children exposed to child sexual abuse (CSA) vary considerably with regards to their presenting concerns and treatment needs. One factor creating heterogeneity amongst children experiencing CSA is their history of experiencing other victimizations (i.e., poly-victimized or not). However, little is known about risk factors for poly-victimization as well as differences in protective factors among these two groups. Additionally, there is currently limited understanding of whether poly-victimization is associated with greater trauma symptoms in children exposed to CSA and being seen for trauma treatment. Using a clinical sample of 117 children who were sexually abused (64 CSA only and 53 poly-victimized) ranging from age 3–18 years, the current study examined demographic characteristics, abuse characteristics, trauma symptoms, and protective factors using casefile review methodology. After accounting for other risk factors, parental abuse history and protective factors were significantly associated with child poly-victimization status. Children exposed to poly-victimization were more likely to have financial concerns = 4.16, p = 0.04, parents with abuse histories = 8.93, p = 0.003, and parents with histories of mental health or substance use difficulties = 4.02, p = 0.045. Although cumulative trauma symptoms scores were higher for children who were poly-victimized compared to CSA only, t₍₁₁₅₎ = −2.24, p = 0.03, multiple regression analyses showed that poly-victimization status was not significantly associated with child trauma symptoms after accounting for other demographic and abuse characteristics. Assessing and …