Aim: Emerging global networks of human rights activists, doctors, and nurses have advocated for increased collection of medical evidence in conflict-affected countries to corroborate allegations of sexual violence and facilitate prosecution in international and domestic courts. Such initiatives are part of broader shifts in human rights advocacy to document human rights violations using rigorous, standardized methodologies. In this paper, I consider three principal forms of medical evidence to document sexual violence and their use in these settings: the patient medical record, the medical certificate, and the sexual assault medical forensic exam (commonly known as the “rape kit”).

Methods: Combining archival research with interviews of activists, healthcare practitioners, lawyers, investigators, and other experts, I trace the collection and use of medical evidence to document mass rape since the establishment of the International Criminal Tribunals for Rwanda and the former Yugoslavia.

Results: The use of medical evidence collection techniques to document sexual violence during and shortly after armed conflict or mass violence against civilians is still relatively new and not well institutionalized. When available, medical evidence has been used to document patient disclosures, describe patterns of crime, prompt investigation, issue indictments, and provide context evidence to establish international crimes occurred.

Conclusions: Drawing on approaches in science and technology studies, law and society, and cultural sociology, I argue that medical evidence collection techniques represent an emerging humanitarian technology that may influence what comes to count as sexual violence, which crimes are deemed justiciable, and ultimately how events come to be remembered, within and beyond courts.