Introduction: Child sexual abuse (CSA) adversely affects a child’s growth and well-being. This study aimed to describe the profile of children presenting to a tertiary paediatric emergency department (ED) with CSA. Methods: Children 0–16 years old presenting to KK Women’s and Children’s Hospital ED from June 2016 to August 2020 with sexual abuse were retrospectively reviewed. We performed a secondary analysis on girls and stratified them by age <13 and ≥13 years o ld. Results: There were 790 patients who made 833 visits for CSA. Victims were predominantly girls (747, 94.8%) and perpetrators were predominantly men (763, 96.6%). The abuse first occurred before the age of 13 years in 315 victims (39.9%). For 468 (59.2%), more than one incident occurred before presentation. Compared to girls ≥13 years old, girls <13 years old were more frequently abused by a family member (47.7% versus 8.0%, P<0.001) and abused in their own home (55.7% vs 21.0%, P<0.001). Among all children, parental divorce and the absence of one or both biological parents in the household were prevalent, with 287/783 (36.7%) having divorced parents, and only 374/784 (47.8%) residing with both biological parents. Conclusion: The findings highlight common characteristics of CSA cases, and can aid the future identification and protection of vulnerable children. The fact that most children presented after more than one incident suggests the need to more closely monitor and protect potentially at-risk children. Keywords: Child abuse, child sexual abuse, child welfare, sexual abuse