The aim of this study was to provide a clearer understanding of the process and context of sex trafficking from Nepal using data from trafficked women themselves. It develops a conceptual framework of the trafficking process and uses this to identify detailed strategies for reducing the risk of trafficking. Quantitative data were analyzed from case records of 202 sex-trafficked women at rehabilitation centers in Nepal. In-depth interviews with 42 sex trafficked women, mostly residing at rehabilitation centers in Kathmandu, provide contextual information on the process and circumstances of sex trafficking. The results of this study provide a clearer understanding of the stages of movement through the sex trafficking process; in particular that sex trafficking does not always begin at the village level, it may also occur after voluntary migration or after trafficking to urban areas for other purposes (i.e., labor exploitation). Interventions therefore need to target each stage of movement through sex trafficking. Respondents were most commonly sex trafficked by familiar persons, including relatives; and force and abduction are less common. Women exited from sex trafficking through rescue, escape or release. One of the outcomes of sex trafficking is a return to sex work upon return to Nepal.