Objectives: Acquaintance rape is the most common type of rape perpetrated against college women, but little information exists on later encounters with the perpetrator, lifestyle changes, and symptoms of posttraumatic stress disorder (PTSD). Participants: The sample consisted of 463 college-attending females, 16% of which indicated they were raped since attending college. Methods: The current study examines the incidence and effects of acquaintance rape perpetrated against female college students at a large, public university in the southeastern United States. Results: Eighty-four percent of the women who indicated they had experienced a rape since attending college knew their perpetrator, and 65.5% encountered their perpetrator after the attack. Participants who encountered their perpetrator after the attack reported more lifestyle changes and higher PTSD symptom severity on the PTSD Checklist for DSM-5 (PCL-5). Conclusions: The current research suggests that the effects of acquaintance rape in college is a complicated area needing further research. There is evidence to support negative effects on victims based on interactions with perpetrators.