This study examined experiences with sexual violence among black African gay, bisexual, and other men who have sex with men and transgender women in townships surrounding Pretoria, South Africa. Of 81 gay, bisexual, and other men who have sex with men and transgender women interviewed, 17 reported to have experienced sexual violence perpetrated by other men. Qualitative analysis of interviews revealed the social and relational contexts of these experiences as well as their psychological and health consequences. The described context included single- and multiple-perpetrator attacks in private and public spaces, bias-motivated attacks, and violence from known partners. Several participants reported refusing propositions for sex as a reason for being victimized. HIV-positive individuals were overrepresented among survivors compared with the sample as a whole. Following victimization, participants described feelings of pain, fear, anger, and self-blame. The results demonstrate the need for interventions designed to (a) prevent sexual violence against gay, bisexual, and other men who have sex with men and transgender women in this population, and (b) reduce the negative psychological and health outcomes of sexual victimization. The discussion also highlights the need to examine more closely the link between experiences of sexual violence and the risk for HIV infection.