Peggy Phillips, 43, is charged with sexual assault of a child.
The alleged affair began around eight years ago, police in Pasadena, Texas, said.
Phillips is accused of having sex with the boy on several occasions between 2007 and 2009 when he was 15 to 16 years old, court documents show.
The suspect allegedly first assaulted the boy when he was in hospital, local news station KHOU reported.The station said police claim the relationship continued after the boy moved in with his aunt and uncle in Pasadena from South Carolina.
Court documents state the boy had sex with the woman "hundreds of times after that inside the house".
The teenager's uncle reportedly told investigator he took the boy into his home because he was in "a bad situation in South Carolina", but everything "went south" about two weeks after he moved in during the summer of 2008.
The woman also allegedly sent inappropriate photos and text messages to the teen.
Phillips is now being held custody in lieu of a $30,000 bond payment.
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