Research has shown that experiencing a sexual assault results in significant and lasting effects in many psychosocial domains. However, most studies on the impact of sexual assault examine university samples or the immediate aftermath of the assault, not taking into account the longer-term complexities and contexts of life for many victims. The current study seeks to evaluate the role of lifetime sexual assault history on several psychosocial outcomes in adults who are in intimate relationships that have included both intimate partner violence (IPV) and alcohol use disorder. The study included 100 adult romantic couples who were part of a larger project addressing violence and alcohol use. A majority of participants were Caucasian (74.3%) and female (53%). Participants reported on lifetime sexual assault history, depression, perceived stress, maladaptive cognitive emotion regulation, and perceived intimate relationship functioning. Multilevel analyses controlled for couple interdependence as well as current levels of alcohol use and IPV. Results indicated that the presence/absence of sexual assault was only related to perceived life stress ( p = .016), while the total number of lifetime assault experiences was related to depression symptoms ( p < .001), perceived life stress ( p = .052), maladaptive cognitive emotion regulation ( p = .048), and dyadic adjustment ( p = .003). These findings underscore the importance of investigating sexual assault outcomes in complex populations, as well as the need for more thorough and regular assessment of sexual assault history. Focusing on empowerment and recovery for sexual assault victims of any age is an important tool to prevent the detrimental outcomes that particularly accompany multiple victimizations.