Elderly sex offenders account for a very small proportion of sex offenders. However, they present providers of sex offender treatment with unique challenges, problems, and resources. A multitude of medical problems, poor education, minimal financial resources, and limited social support combine to produce persons who require multifaceted coordinated care but have limited resources of their own. Some 50-60 years of offending behavior and its accompanying cognitive distortions and deviant fantasies present a major challenge for clinicians. Therapists must alter treatment practices to suit the pace and abilities of these fragile clients. Nevertheless, working with this population can be rewarding and enlightening for the therapist. This work requires challenging our prior beliefs about aging and the issues related to the end of life. The rewards are the prevention of recidivism and the satisfaction of watching and helping someone become a more honest and less destructive person. 32 references