Child sexual abuse has reached epidemic proportions. Incarceration of the most severely entrenched adult sex offenders is a necessary element of a comprehensive prevention strategy, but it is highly questionable whether it should receive the current emphasis. Nearly 40 percent of all child sexual abuse is perpetrated by youths less than 20 years old; children ages 6 to 12 years of age are the source of 13-18 percent of all substantiated child sexual maltreatment. Research on children with sexual behavior problems has revealed that these children have usually experienced sexual abuse and often have experienced multiple forms of maltreatment. Research on these children has also revealed that they can make clinically and statistically significant change after only 16 weeks of specialized treatment. Effective treatment of these children and their families must involve collaboration among treatment providers, school personnel, child protective service workers, and other social service agencies. In addition, sentencing practices for adult sex offenders and dispositions for juvenile abusers should fully consider each individual’s strengths and weaknesses, as well as the needs of their victims. Finally, it may be time for government agencies such as the Centers on Disease Control and Prevention to demonstrate leadership in supporting the implementation of health promotion strategies to prevent child abuse. Table and 62 references