Sexual assault has been identified as a public health crisis. Native American women in the United States who live on federal Native American reservations are disproportionately more likely to be victims of sexual violence than other groups living in the United States. Like many victims of sexual violence, often Native women deal with adverse health effects. Native American women who have been sexually assaulted on a reservation are often unable to access necessary resources because of a myriad of issues, such as poverty, child abuse, colonization, and complex jurisdictional issues. There must be more cultural sensitivity and increased awareness when working to address this issue. Additionally, each tribe must be approached separately because each tribe experiences sexual assault on the reservation differently. There must be understanding that generalizability of all Native American tribes and sexual assault is ineffective. Education, advocacy, and legislation are the major models for change.