OBJECTIVE This study examined whether women with a history of early-onset sexual abuse or those with late-onset sexual abuse were more likely to meet diagnostic criteria for both borderline personality disorder and complex posttraumatic stress disorder (PTSD). METHODS The Revised Diagnostic Interview for Borderlines and the Trauma Assessment Package were administered to 65 women from three outpatient clinics in a metropolitan area. Thirty-eight subjects met criteria for early-onset abuse, while 27 subjects met criteria for late-onset abuse. RESULTS The diagnoses of both borderline personality disorder and complex PTSD were significantly higher in women reporting early-onset abuse than in those with late-onset abuse. The trauma variables sexual abuse and paternal incest were significant predictors of both diagnoses. CONCLUSIONS In contrast to those with comorbid diagnoses, some women with a history of childhood sexual abuse may be extricated from the diagnosis of borderline personality disorder and subsumed under that of complex PTSD.