Past research indicates that childhood sexual abuse (CSA) is associated with various negative outcomes in adolescence and adulthood. Adolescents who have experienced CSA are at a higher risk of suffering from internalizing and externalizing problem behaviors such as anxiety, depression, aggression, delinquency and substance abuse as compared to their counterparts who have not faced maltreatment. While a lot of the research points to the fact that CSA is associated with a range of adverse outcomes during development, evidence linking childhood sexual abuse and substance abuse in adolescence shows conflicting results. Also, potentially traumatic events (PTEs) among children result in the development of trauma cases which set an individual to distress as they seek for measures that will help them deal with their past life events. Although previous research does not show a clear relationship between CSA and substance abuse during adolescence, various moderating factors such as the gender of the victim, age of the victim, the magnitude of the abuse and the relationship of the perpetrator to the victim determine the severity of the effects of CSA. These factors will be evaluated in this review as the main mediating elements that relate childhood sexual abuse with substance abuse during adolescence.