The purpose of this study was to examine whether standardized abuse scales would elicit over-reporting (false positives) or under-reporting (false negatives) of abuse among sadomasochistic participants. Thirty-three women, 21 men, and two transgender individuals (n = 56) volunteered. Half the participants had experienced a previously abusive Bondage, Discipline, Sadomasochism (BDSM) relationship; the other half had experienced a nonabusive BDSM relationship. BDSM practice can make the diagnosis of abuse more difficult in two ways. First, BDSM practitioners in abusive relationships might mistakenly classify the abuse as BDSM, leading to false negative diagnoses. This possibility was not supported; that is, participants did not under-report abuse. Second, BDSM practitioners in non-abusive relationships might be mistakenly diagnosed as being in an abusive relationship due to the nature of their consensual BDSM activities. This possibility received some support. In addition, two a priori categories of the six abuse scale items were defined: (a) items describing behaviors that appear in many sadomasochistic scenes and, as a result, were hypothesized to most likely elicit false positive responses, and (b) items that describe behaviors that are most likely to be abusive in or out of a BDSM context. As predicted, the first category of items elicited false positives and the second category of items successfully diagnosed abuse.