Alcohol use and sexual assault are major public health concerns on U.S. college campuses. This study examined the associations among post-traumatic stress symptoms (PTSS), rape acknowledgment, and alcohol use among 170 college student rape survivors. A negative binomial regression was used to analyze main effects and to run moderation models. In these models, we controlled for sexual assault severity and demographic variables. Rape acknowledgment was significantly associated with lower alcohol use (B = -0.784, SE = 0.324, p = .015), and sexual assault severity was positively associated with alcohol use (B = 0.025, SE = 0.005, p < .001). PTSS was not significantly associated with alcohol use in the main effects model (B = -0.013, SE = 0.010, p = .196). However, moderation analyses revealed a significant interaction between PTSS and rape acknowledgment (B = 0.055, SE = 0.026, p = .032). Specifically, the association between PTSS and alcohol use was stronger among survivors who acknowledged their experience as rape. These findings suggest that acknowledgment status may shape the way posttraumatic stress symptoms relate to coping behaviors such as alcohol use. Implications include the importance of assessing acknowledgment status in clinical settings and tailoring trauma-informed interventions to survivors’ experiences.