Despite a decline in the incidence of child abuse over the last decade, victimization rates remain troubling. This study used a subset of data from the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program to investigate and compare the demographic, psychosocial, and service use characteristics and outcomes of children with varying abuse histories referred into community-based mental health services. The lifetime estimate of abuse histories--physical, sexual, or both--among these children is 36.5%. A high level of clinical need across abuse subtypes and a gradient of increasing child and family risk factors differentiated children with and without an abuse history. Children with a reported history of both physical and sexual abuse consistently presented a more troublesome picture of personal and family challenges. Implications for the assessment of clinical needs and the identification of evidence-based interventions to meet the unique needs of these children are discussed.