This retrospective review of sexual assault cases seen in an emergency department from 1993 to 1999 examined rates and characteristics of suspected drug-facilitated sexual assault (DFSA). Overall, 12% of cases were identified as suspected DFSAs. The rate of suspected DFSA in 1999 was more than double that in the preceding six years. As well, compared to other sexual assaults, suspected DFSA cases had a longer time delay in presenting to the hospital, were less likely to involve the police, and had a lower occurrence of both genital and extra-genital injury. The clinical implications of these findings, particularly in terms of toxicology evidence collection, are discussed.