Using a nationally representative sample of 791 youth, ages 8-17 at baseline, this study identified patterns over a 2-year period in specific forms of peer victimization and examined differences in the mental health consequences of those patterns. Findings show that, among the victimized, physical assault had relatively high persistence compared to other forms, while physical intimidation and emotional bullying had relatively high rates of desistence. Emotional bullying at T1 was associated with increased risk of T2 Internet harassment and Internet harassment at T1 strongly predicted T2 dating violence. Patterns of victimization over time differed in their relationship with trauma symptoms. Findings emphasized the importance of recency and the distress of new victimization experiences, rather than the chronicity or repetition of victimization. Understanding variations in peer victimization patterns and outcomes over time can help to inform interventions that better target sources of risk across adolescence.