An exploration of the etiology of juvenile sex offending shows that most professional attention to date has focused on the observed association between juvenile sex offending and a prior history of childhood maltreatment. It has been found that 40-80 percent of male juvenile sex offenders report a prior history of sexual victimization and 25-50 percent a history of physical abuse. Rates of sexual victimization are apparently even higher in samples of prepubescent male and adolescent female sexual perpetrators. In addition to maltreatment experiences, the risk of juvenile sex offending may be heightened through exposure to peer and domestic violence, pornography, and drug and alcohol abuse. Adolescent male sex offenders have been clinically described as suffering from a number of psychosocial and behavioral problems, including poor impulse control and disinhibition, low self-esteem and social skill deficits, deviant sexual arousal and interests, tendencies to endorse beliefs that are associated with minimizing the seriousness of sexual perpetration or justifying the behaviors, generalized psychopathy and antisocial attitudes, and deficits in empathy and sexual knowledge. The careful assessment of adolescent sex offenders is critical to formulating recommendations regarding disposition. The clinical interview provides the foundation for the assessment process and should be conducted with sensitivity to both process and content issues. Given that juvenile sex offenders are a relatively heterogeneous population that reflects an array of psychosexual and non-sexual problems and levels of disturbance, a continuum of care is required to meet their treatment needs. This chapter identifies key components of both community-based and intensive residential treatment programs. 42 references