Explored relationships between trauma related to physical or sexual abuse, posttraumatic stress disorder (PTSD), and medical utilization in 3 patient groups reported to be at high risk for trauma exposure. 107 20-81 yr old medical center patients were surveyed using the Trauma History Questionnaire and the PTSD Checklist. Ss included 48 gynecologic outpatients, 35 inpatients with seizure disorders, and 24 psychiatric inpatients with non-PTSD admitting diagnoses. Medical utilization data were obtained from a medical center data base. Results show that 96 patients reported a trauma history and of these, 66 reported abuse and 45 qualified for PTSD diagnoses. Total number of traumas and reported abuse correlated significantly with elevated medical utilization and PTSD prevalence. PTSD diagnosis was not significantly correlated with utilization, but the 5 highest utilizers received PTSD diagnoses. It is concluded that these results support hypotheses regarding the relation of trauma exposure to medical utilization, but are less clear about the mediating role of PTSD. These findings suggest that routine screening of high-risk patient groups might promote timely identification of trauma history and PTSD, and subsequently affect health care utilization.