Introduction: Sexual assault is a major public health and criminal justice issue in Guinea. The vulnerability of victims, often minors, justifies detailed epidemiological and medico-legal analysis. This study described the profile of victims examined at the Department of Forensic Medicine of the Regional Hospital of Conakry and assessed the influence of age and consultation delay on traumatic injury detection. Methods: A retroprospective descriptive and analytical study was conducted on sexual assault cases recorded between 2021 and 2025. Variables included victims’ sociodemographic characteristics, assault circumstances, medico-legal findings, consultation delay, and perpetrator characteristics. Descriptive statistics, Chi-square tests, and Odds Ratios were used. Results: Among 7645 medico-legal consultations, 929 sexual assault cases were identified (12.16%). Victims were predominantly female (99.78%) with a mean age of 16.64 years. Minors formed the majority and were more likely than adults to present traumatic injuries (45% vs 28%; OR = 2.10; 95% CI: 1.55 - 2.83). Injury detection decreased significantly with increasing examination delay (48.2% within 24 h vs 9.7% after 72 h; p < 0.0001). Assaults were mainly extra-familial (70.08%) and frequently occurred at the perpetrator’s residence (47.47%). Perpetrators were exclusively male with a mean age of 29.8 years. Conclusion: Sexual assaults mainly affect adolescent girls and young women. Early medico-legal examination and the vulnerability of minors significantly influence injury detection. Strengthening rapid referral, protection of minors, and medico-judicial responses is essential in Guinea.
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