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Background: Childhood maltreatment (CM) could increase the risk for developing posttraumatic stress disorder (PTSD) in adulthood, especially for women.But it was unclear about the biological pathway through which CM contributes to PTSD.The hypothalamic-pituitary-adrenal (HPA) axis is one of the biological systems that could launch the physiological response to stress such as CM.Altered cortisol levels, which reflect the HPA axis dysregulation, may play an important role in the pathophysiology of PTSD.Exploring the biological mechanism accounting for the associations between CM and PTSD could assist in developing interventions targeting PTSD symptoms in the vulnerable population such as women.