Although rape and other forms of sexual violence have historically been present during wartime, it has recently become a strategic weapon of war in many settings. The term mass rape as a weapon of war is defined as a systematic pattern of rape perpetrated by fighters usually against civilian women and children at a rate much higher than the rate of rape prevailing during peacetime. This study will examine issues surrounding mass rape as a weapon of war including: emerging theories, effectiveness of current international law, public health consequences, and relevant indicators of likelihood of occurrence. Grave physical and mental health outcomes associated with mass rape highlight the need for intervention through policy and program planning. The proposed multi-dimensional prevention pathway addresses the ecological determinants of mass rape.