Alcohol intoxication is often involved for both victims and perpetrators of sexual victimization. Yet, alcohol-involved sexual victimization research has mainly focused on female victims, excluding male victims. The current study addresses gaps in the literature by focusing on sex differences in the emotional harms (anxiety and depression symptomatology) experienced by sexual victimization victims when either the perpetrator or victim was drinking. Five-hundred-and-ten undergraduate drinkers (153 male; 357 female) participated. Models included two dichotomized predictors that occurred during participants’ first year of university (sexually victimized when the victim was drinking, sexually victimized by someone who was drinking), and two emotional outcomes (anxiety, depression). Age was controlled in all path analyses and sex was examined as a moderator. When predictors were examined in separate models, both predictors were associated with increased anxiety but not depression. These effects were significantly stronger among men. When both predictors were entered simultaneously, individuals who were victimized by someone drinking displayed increased anxiety, and this relationship was stronger among men than women victims. Being victimized when drinking was no longer associated with anxiety, consistent with prior findings that post-traumatic distress may be minimized when a trauma occurs while the victim is intoxicated. Results highlight the impact sexual victimization can have for both male and female victims, and point to the need for evidence-based policies to prevent emotional second-hand alcohol harms among male and female students alike.