Background: Adolescents who initiate treatment for substance abuse often have a history of victimization in the form of physical, psychological, or sexual abuse. These experiences can have serious adverse consequences that may affect their lives and social functioning. Objective: This article describes and analyzes victimization among adolescents who are in outpatient treatment for substance abuse disorders with respect to gender, social circumstances, alcohol and drug abuse, and mental health. Method: This cross-sectional study is based on structured interviews with 748 adolescents from seven outpatient clinics in Sweden. Chi-squared tests were performed to examine significant differences between gender and victimization (or lack of victimization). The study also included a quantitative content analysis of interview utterances. Results: The analysis showed that more than half of the adolescents had experienced violence or another type of abuse. There are also significant gender differences: two thirds of the girls and slightly less than half the boys had experienced abuse in some form, and the girls had more severe needs at treatment admission. Conclusion: This study established that experiences of victimization and exposure to violence are widespread among adolescents with substance abuse disorders in Sweden. This is an important issue that requires attention and action, with preventive and therapeutic interventions needed to provide support for both substance abuse disorders and psychiatric symptoms.