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Background: Language is the most common way to communicate internal states and emotions into a narrative form. Studies on the use of language provide a useful understanding of how people process an event and interpret it. Objective: The aim of this study was to investigate the effects of PTSD on the narrative coherence of children's reports of sexual abuse. Participants and setting: Narrative coherence was analyzed within a group of 89 allegations of children (M = 10; range: 4–16), who were victims of sexual abuse. Thirty-seven children presented the symptoms for a diagnosis of PTSD. Method: Linguistic Inquiry Word Count (LIWC) was employed and narrative coherence was analyzed through some linguistic markers (first-person singular pronouns, conjunctions, and cognitive words). Results: Results illustrated the effects of PTSD on the narrative coherence, in terms of first-person singular pronouns, conjunctions, and cognitive processes. Indeed, compared with traumatic narratives of children without PTSD, traumatic narratives of children with PTSD contained a greater number of first-person singular pronouns (MPTSD = 1.45 versus Mno-PTSD = 1.12) and a smaller number of conjunctions (MPTSD = .37 versus Mnon-PTSD = .67), cognitive (MPTSD = 2.93 versus Mnon-PTSD = 3.76) and insight words (MPTSD = 2.29 versus Mnon-PTSD = 3.09). Regression analyses were used to examine if age and PTSD were predictors of the narrative coherence, suggesting the effects of PTSD in predicting the use of the first-person singular pronouns and the conjunctions. Conclusion: This study could underline the importance of considering the PTSD in legal testimony of children who have been sexually abused.