Existing research has identified various reasons most sexual assault victims do not seek help. There remains a need, however, to highlight Black women’s experiences to better understand and adequately meet their needs when they seek help. This project extends existing bodies of knowledge by centering Black women, situating their experiences within a Black feminist framework, and evaluating their experiences as they seek help to understand factors that shape their reporting decisions. Findings suggest that as Black women seek medical help, they consider culture-specific and real rape factors during the police reporting decision. Key findings, implications, and policy recommendations are discussed.