This Wrap outlines key issues in institutional and care settings with identifying and responding to women’s recent and past experiences of sexual assault. In this paper, we draw together the common or shared elements of various institutions identified in the literature. We consider the historical socio-political context of women’s institutionalisation. Then we consider the prevalence of sexual assault, both current and historical, within various institutional settings and explore some of the barriers to disclosing and responding to sexual assault within these settings. Finally, we discuss the relevance of cultural and structural issues in responding to address sexual assault within institutional settings.