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Sexual assault and other adverse childhood experiences (ACEs) can have lasting effects, impacting mental and behavioral health as people transition to adulthood, including those transitioning to college. This study uses survey data from a sample of 486 first time in college, first-year students at one large public university in the southern U.S. to examine any unique influence of sexual assault experienced before college, taking into account other pre-college adverse life experiences, including those that were COVID related. ACEs were measured using a modified version of the Life Stressors Checklist to ask participants about 33 different ACEs. Eighteen percent (n = 88) of students in the sample experienced a sexual assault before college. Students who experienced a sexual assault before college were more likely to also have experienced at least one traumatic ACE that was not sexual assault (χ2 (1, 451) = 6.83, p < .01). Additional analyses examine the impact of sexual assault accounting for other ACEs on symptoms of post-traumatic stress, anxiety, and depression, as well as alcohol use. Results may help those who work with college students take a more holistic accounting of life experiences in devising support resources.