In Hong Kong, it was estimated that there were at least 200,000 female sex workers (FSWs) in 2002 and the total female population involved as workers, supporting staff and partners of the male clients exceeded half a million in a city of 6.8 million people. A self administered questionnaire comprised of 6 different domains, focusing on health behavior, environment and lifestyles was administered to a total sample of 89 FSWs, in addition, one focus group was conducted. The mean age of the FSWs interviewed was 36.1 years with the majority having received no more than junior high school education. Sixty-eight women (76.4%) had been in Hong Kong for less than one year and 35 (39.3%) for less than three months. A total of 14 (15.7%) of the women reported being robbed and verbally abused by client respectively. Furthermore, 7 (7.9%) of the women had been beaten by clients. A number of women (12.4%) had been insulted by passers-by. Many women felt physically unsafe and 18 (20.2%) reported only receiving irregular payment. Recommendations are to promote FSW peer education and empowerment and to address the complex stigmatization and victimization that operates for FSW. It is paramount to address the complexity of mental health risks and costs in relation to commercial sex which are further compounded by underlying factors of poverty, illegal statuses, marginalization, ethnicity and uncertainty so informing anxiety and depression outcomes.