Prevalent forms of child sexual exploitation are (1) the use of a child by the parent or someone in loco parentis for his/her own sexual needs; and (2) the use of a child in explicit sexual performances, whether for prostitution, sexual exhibition, or pornography. The sexual exploiters of children most often select their victims from their own families, buy them from others, or recruit them from runaways. The number of children in the United States engaged in prostitution is estimated at about one-half million, and the use of children in pornography is reflected in the 264 different magazines published each month which portray children in sexual acts with one another and with adults. Psychiatrists maintain that exploitative and coercive sexual activity with children predisposes them to join society's deviant populations of drug addicts, prostitutes, and criminals. Actions to counter the growth of child sexual abuse should include (1) the amendment of child abuse and neglect statutes to include sexual exploitation and to prescribe harsh criminal penalties for offenders; (2) the amendment of the civil code to provide for the licensing of all children used in commercial modeling or performing, with carefully worded proscriptions and substantial sanctions against the use of such children in sexually explicit activities; (3) the extension of criminal liability to promoters and distributors of child pornography; (4) the strengthening of sexual assault and incest statutes and the modification of the judicial process of presenting evidence where young children are involved; and (5) the development of intervention and treatment models for children sexually victimized. Guidelines are listed for preparing the child or adolescent for court, and some examples of treatment strategies for helping child sexual abuse victims are outlined. Fifteen footnotes are provided.