The review examines the existing peer-reviewed scholarly and grey literature from industrialized and developing regions. Over 400 items on sexual assault, including books, journal articles, news articles, research reports, annual reports, discussion papers and monographs were examined. The review outlines the historical and contemporary medico-legal responses to sexual assault victims, broadly describing the professionals, protocols and procedures involved in the collection and processing of medico-legal evidence. Findings are presented from studies that have evaluated the legal impact of such evidence in sexual assault cases, and factors that may create barriers to its successful use in criminal justice proceedings are discussed. The review identifies salient knowledge gaps and offers research recommendations for addressing them.