Using cross-sectional data over a 4-year period (2009–2013) from a regional sample of middle and high school students in southeastern Michigan, researchers studied peer-to-peer sexual violence victimization and perpetration among male and female adolescents in a large, racially and economically diverse, community-based sample. Data showed that most peer-to-peer sexual victimization and perpetration was committed by someone of the opposite sex; same-sex victimization and perpetration, however, were not uncommon. There was also an association of substance use, depression, attention-deficit/hyperactivity disorder, and conduct disorder with peer-to-peer sexual violence for both males and females, with few differences in the patterns of associations by sex. For both male and female youth, these discoveries are an important step in better understanding the types of peer-to-peer sexual violence that adolescents experience and risk factors.