The reliability, and therefore the validity, of diagnoses of paraphilias, diagnostic categories among sexual offenders, appears to be poor. It is suggested that clinicians working with sexual offenders avoid diagnostic considerations where possible, and focus instead on each client’s various problems construed as dimensions of functioning. A helpful approach would be to rate the features of each type of sexual offender along dimensions ranging from normal to seriously problematic. The next consideration is given to the evidence on the incidence of multiple paraphilias and comorbid disorders. Treatment suggestions are offered on the treatment of both multiple paraphilic offenders and those with associated comorbid disorders. Many clinicians are required by their job circumstance to apply a diagnosis to their sexual offending clients, while others find it essential to the proper treatment of their clients. Researchers examining sexual offenders typically use diagnostic descriptors. The intention of this article is to consider these issues in some detail and to offer an alternative approach. It appraises the criteria for the Diagnostic and Statistical Manual (DSM) diagnoses of the paraphilias relevant to sexual offenders. Table, references