Child sexual abuse (CSA) is common throughout the world and has been recognized as a common presentation at the Eastern Highlands Provincial Hospital. The aim of this prospective study was to describe the presentations and outcomes of CSA in the hospital. A structured questionnaire was used to collect data from the guardians of 38 children aged between birth and 15 years presenting with a history of sexual abuse between February and August 2013. Children were followed up at three months to ascertain the presence of sexually transmitted infection and to determine how the issue of abuse was resolved by the family. There were 35 females and 3 males aged between 3 and 15 years with a median age of 5.5 years and interquartile range of 4-9 years. 28 (80%) of the 35 girls had been raped and one of the boys had been anally raped. Over half of the children’s mothers were illiterate and lived a subsistence lifestyle. The perpetrator was known to the subjectin 36 (95%) of the cases. Coercion was used by the perpetrators in 22 cases (58%). Gram stains of vaginal swabs from 28 children showed gonococci in 15 (54%). Compensation payments were used to resolve the issue of abuse in 13 (72%) of 18 cases at 3-month follow up. There has been an increase in the number of children diagnosed with sexual abuse at the Eastern Highlands Provincial Hospital. There is an urgent need for existing child protection laws such as the Lukautim Pikinini Act to be robustly implemented and for the development of Family Welfare Centres to provide a holistic approach to the management and support of victims of CSA and their families.