Mr Cosby is accused of drugging and molesting a former Temple University employee in his home near Philadelphia in 2004.
The case was opened last year after dozens of women came forward with similar accusations.
Mr Cosby has maintained that all of the encounters were consensual.
Police read a statement from the accuser, Andrea Constand, who now lives in Toronto.
"I told him, 'I can't talk, Mr Cosby'. I started to panic," Ms Constand told police in 2005 following the incident, describing how Mr Cosby allegedly sexually violated her after giving her three blue pills.
The pills made her dizzy and made her legs "like jelly".
Mr Cosby said she never told him to stop during the encounter.
His arraignment is 20 July. He is facing civil lawsuits in other states over the other accusations.
Andrea Constand says she was assaulted by Mr Cosby in 2004The judge has ruled that she will not have to testify.
More than 40 women have accused Mr Cosby of sexual assault, but in nearly all of the cases, too much time has elapsed for charges to be pursued.
The Constand case is the only one that falls within the statute of limitations for charges.
At the scene - Laura Bicker, BBC News
This was not the showdown some had been either hoping or fearing. Andrea Constand, the woman at the centre of this allegation, was not in court to face the accused. The defence has tried to use this to its advantage - arguing that the evidence on which this preliminary hearing is based is mere hearsay. And that a full criminal trial should not be based on the words of a statement written 11 years ago - a year after the alleged incident.
Bill Cosby is here to hear the evidence. He was helped into court - but stopped to adjust his suit and wave to cameras and reporters.
Sitting a few rows behind his bench was Gloria Allred carefully taking notes. She represents some of the 56 women who have come forward with similar accusations. She's also from Philadelphia and has made the trip back from her new home in Los Angeles for this hearing.
Mr Cosby is best known for his role as the father in the television hit The Cosby Show which ran from 1984 to 1992 and was a huge hit in the US and around the globe.
It made the comedian one of America's most popular entertainers.
The 78-year-old comedian, once the highest paid US television star, could go to prison for 10 years if convicted.
Ms Constand has said that she came to think of Mr Cosby as a "mentor and a friend" before she said he made unwanted sexual advances.
She went to visit him at his home in 2004 where she said he drugged and sexually assaulted her.
A criminal complaint unsealed last year details the encounter.
Prosecutors allege that the victim protested when Mr Cosby offered her a glass of wine, saying she had not eaten that day.
He urged her to drink wine anyway, Ms Constand said in her testimony, so she drank a few sips along with the pills.
Within 30 minutes, she says she experienced blurred vision and had trouble speaking. Mr Cosby then told her to lie down on the couch and relax.
During that time she was lying on the couch, she says she was aware of Mr Cosby moving toward her, touching her breasts and genitals, and making her touch his genitals.
She says she did not consent to any of the acts, that she could not speak, and that she felt "frozen" and "paralysed".
Prosecutors re-opened her case last summer. She and Mr Cosby settled a lawsuit in 2006 and she was paid an undisclosed sum.
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