BACKGROUND: Sexual assault (SA) and the underreporting of SA are highly prevalent in the United States. Since regret is a complex, negative emotion linked to decision making, studying regret within the context of reporting SA is important. OBJECTIVE: To describe decisional regret regarding SA reporting. DESIGN: A cross-sectional, descriptive study design was used. The sample included 78 individuals, aged 18 to 25 years, who experienced SA during the past 5 years and completed an electronic questionnaire. A multiple regression model was generated to describe how selected independent variables explain variation in levels of regret. RESULTS: In the final model, four independent variables accounted for 33.3% (adjusted R2) of the variation in regret: weight change, stranger assailant, professional treatment, and police reporting. CONCLUSIONS: The findings inform clinical practice by describing post–decisional regret about the reporting of SA, and they provide a foundation to develop strategies (e.g., decision aids) that can assist clinicians to help patients as they struggle to make difficult health care decisions.