This chapter discusses the history of sexual violence in US universities to see where things have changed and where they have not. It first explains the relevant terms, such as ‘higher education institution’, ‘college’ and ‘university’ as well as ‘on campus’, ‘sexualised violations’, and ‘sexual misconduct’. It then reviews the early research which overlooked the gendered nature of campus sexual violence, the initial efforts that sought to ‘teach women how to stay safe’ which were critiqued for implicit victim-blaming, and more recent prevention approaches which focus on bystander intervention and the role of friends, peers and social networks in preventing violence. It also examines victimisation and perpetration, along with the interrelationships between perpetration dynamics, campus culture and institutional governance. The chapter concludes with an analysis of issues relating to policy framing and victims' formal reporting.