This study examined the direction of association between symptoms of posttraumatic stress disorder (PTSD) and cortisol levels among youth with recent and distal traumas (N = 50; mean age = 10.7 years). Each had a clinical interview for PTSD symptoms, a cortisol assessment, and the time since the child's most recent trauma was assessed. Results indicated that the time since the most recent trauma moderated the association between cortisol and PTSD symptoms and comparisons indicated that there were significant differences in the size of the correlations across the recent and distal trauma groups. The results point to a potentially important role of the time since trauma in understanding the relationship between PTSD symptoms and cortisol.