This study examined the prevalence of victimization and perpetration of sexual aggression since age 15 in a convenience sample of 565 Polish university students (356 females). The prevalence of sexual aggression was investigated for both males and females from the perspectives of both victims and perpetrators in relation to three coercive strategies, three different victim–perpetrator relationships, and four types of sexual acts. We also examined the extent to which alcohol was consumed in the context of sexually aggressive incidents. The overall self-reported victimization rate was 34.3% for females and 28.4% for males. The overall perpetration rate was 11.7% for males and 6.5% for females. The gender difference was significant only for perpetration. Prevalence rates of both victimization and perpetration were higher for people known to each other than for strangers. In the majority of victimization and perpetration incidents, alcohol was consumed by one or both parties involved. The findings are discussed in relation to the international evidence and the need for tailored risk prevention and reduction programs.