The current study evaluated the associations between pre-assault factors, assault characteristics, and multiple sexual assault medical forensic exams (SAMFEs) on emergency department visits one-year post-SAMFE. Characteristics associated with individuals who frequent the emergency department at higher rates have been well established; however, factors associated with greater emergency department visits following a recent sexual assault (SA) are largely unknown. The current study included a medical record review of 123 individuals who received a SAMFE at a hospital in the southeastern United States. Demographic variables, characteristics of the SA, pre-SA diagnoses, frequency of SAMFEs, and post-SAMFE emergency department visits were examined. Results indicated that alcohol or drug use during an assault was associated with fewer emergency department visits post-SAMFE. Substance use and injury disorders pre-SAMFE were positively associated with post-SAMFE emergency department visits. Findings provide important insight for prevention strategies to target mental and physical health concerns after recent SA to mitigate risk trajectories.