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Objective: To evaluate the characteristics of aggression, care, and follow‐up of sexual violence in adolescent women at a university service in Campinas, São Paulo, Brazil. Methods: In a retrospective cohort study from 2011 to 2018, we assessed sociodemographic characteristics, type and form of sexual violence perpetration, background and perception of the victim about violence, and characteristics of care and social/legal support during follow‐up. Results: Of 521 adolescents 242 (46.5%) were aged 10–14 years, 354 (68%) had not started sexual life, 465 (89%) perceived the violence and they had low prevalence of alcohol (71, 16%) and other psychoactive substance consumption (25, 6%), and 24 (4.6%) had an intellectual disability. Intimidation through physical force, acute abuse, vaginal penetration, acquaintance aggressor, being approached in a public place, and family/acquaintance residence were the most prevalent characteristics of aggression. In the 2017–2018 biennium, we observed a decrease in the prevalence of adolescents who were students (P < 0.001), an increase in the number of acquaintance aggressors (P = 0.008), and medical care after 72 hours (P < 0.033). Conclusion: Adolescents were victims of severe sexual violence. There was a decrease in prophylactic treatments and half of the adolescents did not complete outpatient follow‐up. The economic worsening over the last decade may have contributed to these results. When the victim is a teenager, the challenge is permanent: care within the first 72 hours and follow up with multidisciplinary support must be achieved. [ABSTRACT FROM AUTHOR]