This chapter explores the harms and impacts of image-based sexual abuse, drawing on interviews with image-based sexual abuse victim-survivors as well as responses from a national survey. Although image-based sexual abuse may have little impact on some people’s lives, for others, the abuse is experienced as a form of “social rupture” because it leads them to divide their lives into two phases – “before” and “after” the abuse. Victim-survivors described the totality of harms they experienced, across their social, economic, digital, sexual and political lives. Victim-survivors also described the harms as continuous and ongoing. This “constancy” not only amplifies the harms, but it makes recovery and pursuing justice all the more elusive. The chapter also explores the themes of isolation, existential threat and violated trust, as well as considering the parallels with harms experienced by sexual assault victim-survivors.