Purpose: This meta-ethnographic review aimed to synthesize qualita-tive evidence on posttraumatic growth (PTG) among adult survivors of sexual violence, with particular attention to the coexistence of positive change, posttraumatic depreciation (PTD), and potential illusory growth. The review aimed to develop an interpretive framework that captures how survivors understood, narrated, and negotiated growth amid profound psychological, relational, and cultural challenges. Materials and Methods: A systematic search of qualitative studies exploring PTG following sexual violence was conducted across major databases. Eligible studies were analyzed using Noblit and Hare’s seven-step meta-ethnographic approach. First-order (participant quotes) and second-order (author interpretations) data were trans-lated across studies to develop higher-order conceptual themes. Results: Six overarching themes were identified: (1) Meaning Making and Sense Making, reflecting survivors’ efforts to reconstruct coher-ence; (2) Relational Reorientation, capturing shifts in trust, boundaries, and intimacy; (3) Identity & Emotional Transformation, highlighting changes in self-perception and emotional regulation; (4) Spiritual Growth, showing spirituality as both a resource and a site of ambiva-lence; (5) Coping & Resilience, illustrating behavioral and cognitive strategies that facilitated adaptation; and (6) Barriers/Trauma Burden, representing the enduring effects of shame, stigma, and psychological distress. Discussion: Survivors’ narratives revealed a dynamic interplay among genuine growth, lingering distress, and illusory growth shaped by coping demands. PTG in sexual violence survivors emerged as a complex, culturally embedded process involving both transformative change and persistent burdens. Understanding these nuances can inform trauma-informed, strength-based support that honors survi-vors’ lived realities. Conclusion: Implications for practice, policy, and future directions are discussed