BACKGROUND: There is little information on the prevalence and correlates of sexual abuse in adolescents in India. METHODS: A cross-sectional survey of all Class XI students in eight higher secondary schools in Goa (n = 811 ) was conducted in March 2000. A self-report questionnaire, developed and piloted in collaboration with the adolescents, elicited information on education, mental health, risk behaviours and the experience of violence and sexual abuse in the previous year. RESULTS: A third of adolescents had experienced some form of sexual abuse. Sexual abuse experiences were associated with the experience of other forms of physical and verbal violence. Coercive sex had been experienced by approximately 6% of adolescents. These adolescents had significantly poorer academic performance, poorer mental and physical health, greater substance abuse, poorer parental relationships and higher rates of consensual sexual behaviours. Gender differences in the types of abuse and the associations with abuse were found. However, there was no difference between boys and girls in the rates of experience of coercive sexual intercourse. Differences in risks were found for urban and rural school students; while rural boys were more likely to have experienced coercive sexual intercourse than urban boys (10.3% v. 2.5%), urban girls were more likely to have experienced any form of sexual abuse than rural girls (37.2% v. 25.4%). CONCLUSIONS: Abuse and violence in school-based adolescents is a common experience and is associated with poorer health and greater prevalence of risk behaviours. Interventions aimed at improving adolescent reproductive health must incorporate personal safety, prevention of abuse, communication skills and mental health issues.