The Iowa Coalition against Sexual Assault (IowaCASA) was formed in 1981 when several independent rape crisis centers banded together to apply for grant money from the State Health Department of Iowa under the leadership of Carole Meade. Meade, who served as the director of the Polk County Rape and Sexual Assault Care Center, was elected as the first president of the board of directors of IowaCASA in 1982, the year the group was incorporated as a private, non-profit organization. Meade spearheaded efforts to coordinate the services of Iowa's thirteen sexual assault and rape crisis centers, focusing on prevention programs, meeting the needs of survivors, and education.

During IowaCASA's formative years, Meade and one clerical staff were the only two paid employees; a board of directors provided oversight. The organization soon included a vice-president, a secretary, a treasurer, an advocacy committee, a finance committee, an executive committee, an education committee, and several special committees. Any adult living in Iowa could join IowaCASA upon signing a membership application and receiving the approval of the executive committee. Individual members could vote on issues brought before the membership. Regular meetings were held quarterly, and an annual meeting was held during the last quarter of each year.

In 1990, the state of Iowa's Crime Victim Assistance Division began to distribute funds to the fourteen sexual assault crisis centers located in the state; this infusion of state money enabled IowaCASA to expand its presence in Iowa. IowaCASA's services included securing funding for Iowa's sexual assault centers, resource development, public education initiatives on child sexual abuse, anti-pornography work, and self-defense training. The organization began a library of resource materials for issues related to sexual assault. IowaCASA provided training on topics such as campus rape, sexual exploitation by therapists, and the needs of adult incest survivors. During this time, IowaCASA was a vocal opponent of the media's release of rape victims' names.

By 1997, IowaCASA served thirty sexual assault crisis centers and numerous individual members of the organization across Iowa. Several paid staff positions were created during this time, including a training coordinator, a fiscal manager, and outreach staff. During this time of growth, the organization expanded its mission to include work on public policy issues. IowaCASA promoted policies to require that victim counselors be present during proceedings related to sexual crimes, to prohibit the use of polygraph as a precondition of a rape investigation, and to increase the statute of limitations for child sexual abuse.

In 2007, IowaCASA, which included eleven paid staff, served twenty-seven sexual assault crisis centers and individual members across Iowa. The organization provided legal assistance to survivors of sexual assault, reached out to Iowa's immigrant communities, and worked to improve responses to sexual assault in ethnic and racial minority communities in Iowa. IowaCASA also continued to engage in public policy initiatives related to sexual assault on the federal, state, and local levels.