Sexual abuse and psychogenic nonepileptic seizures, Abstract Objective We investigated the frequency of reported sexual abuse in patients with psychogenic nonepileptic seizures (PNES) in a Middle-Eastern culture (Iran) and tried to characterize the association between a history of sexual abuse and the clinical characteristics of PNES in these patients. Methods In this retrospective database study, patients with PNES, who were investigated at Shiraz Comprehensive Epilepsy Center at Shiraz University of Medical Sciences, from 2008 until 2018, were studied. Patients were categorized into two groups: (1) those with a history of sexual abuse and (2) those without such a history. Results A total of 314 patients were studied. Twenty-six patients (8.3%) had a history of sexual abuse, while 288 patients (91.7%) denied having such an experience. Sex ratio (OR: 3.53; 95% CI: 1.14–10.89; p = 0.02) and a history of child abuse (OR: 4.85; 95% CI: 1.82–12.96; p = 0.002) were significantly associated with a history of sexual abuse. Conclusion Some people with a history of sexual abuse are at risk of developing PNES later in their lives. While social, cultural, and even genetic predisposition may be interacting for such an association to come to play, there is no concrete direct evidence to clarify this link yet. This should be investigated in future international cross-cultural studies and also highlights the need for planning genetic studies in patients with PNES.