Alcohol plays a major role in sexual assaults, but few studies have examined its impact on recovery outcomes, particularly in longitudinal studies. In a longitudinal study of 1,013 adult sexual assault survivors, we investigated the effects of victim drinking on posttraumatic stress disorder (PTSD), as well as the mediating role of characterological and behavioral self-blame attributions. In line with some prior research, victims who were drinking before their assault experienced less PTSD, but more self-blame than those who were not. Characterological, but not behavioral self-blame was related to increased PTSD symptoms. Thus, although drinking was overall related to less PTSD, it was also associated with increased PTSD via self-blame attributions, highlighting the danger of blaming victims of alcohol-related rapes for their assaults. Implications for future research and clinical work with survivors of alcohol-related sexual assaults are drawn.