Art is an expression of the child's inner reality. Drawings by child victims of incest might be expected to differ from drawings by other children presenting at a child psychiatry clinic. This study compares drawings by child victims of incest with drawings by children referred to the University of Arizona Child Psychiatry Clinic for nonsexual issues. Each drawing was rated on 15 dimensions, including sexualization of the figure, degree of dependency, quality of ego defenses, and adequacy of impulse control. Child victims of incest were judged to have more poorly developed impulse controls and a defensive structure which emphasized repression. These children were also significantly more variable than their counterparts in the degree to which they expressed sexual features in the drawings, but were less variable in their rated maturity and in the rated adequacy of their ability to use sublimation as a defense against anxiety.