This study focuses on sexual abuse of women in Khyber Pakhtunkhwa and its impact on their social adjustment. In this study, sexual abuse was measured as unwanted or non-consensual physical contact/sexual intercourse between the opposite sexes. Sexual assault or harassment or any other physical or sexual contact, in which intercourse was not committed, were excluded from this study. The target area of this study was Khyber Pakhtunkhwa and the target population was sexually abused women and professionals. A total of 40 samples were taken and two focused group discussions were held. Of these samples, 30 interviews were conducted with the victims of sexual abuse and 10 interviews were conducted with professionals including 05 psychiatrists and 05 sexologists. All the respondents were accessed through social and familial contacts. These respondents were randomly selected. The nature of sexual violence, identified in this study, included fraternal abuse, incestuous abuse, rape and commercial sex. Those women who were given in enmity (swara), priced (trafficked) and bartered (wata sata), were the victims of fraternal abuse. Women, involved in commercial sex, were the victims of elopement, deception, sexual violence and inducement/enticement. In this study, 12 women were the victims of fraternal abuse, in which 03 women were given in enmity, 07 were trafficked and 02 were bartered. In commercial sex, 08 women were the victims of sexual violence, 01 was the victim of elopement, 03 were the victims of sexual deception and 01 was the victim of sexual enticement/inducement. Of 30 victims, 05 women were raped, in which 04 rapes were opportunistic and 01 was incapacitated. Illiteracy, domesticity, authority and coercive control, fear of curse and ex-communication, dependency syndrome, unequal distribution of power and curse of the will, were some of the causes, found in this study that highly restrained women from disclosing their sexual abuse incidences. Familial rejection and denial of share in inheritance were the two main factors, strongly contributed to victims’ vulnerability. Bad reproductive and mental health, suicidal tendencies, drug addiction and alcoholism, prostitution, bad physical and relational health and low self-esteem were some of the impacts of sexual abuse, found in this study. Among the respondents, 04 victims were found with strong suicidal ideation, 13 women were found in commercial sex who had no previous history of involvement in commercial sex. In this study, three main destinations were identified for victims of sexual abuse; death, brothel and excommunication that finally led to prostitution, drug addiction and suicidal temptations. Owing to these three destinations for the victims of sexual abuse, their adjustment in society (Pakhtun social setup) is impossible.