Objective: Neurological disorders can be mis-diagnosed as psychiatric ones when the psychiatric symptoms are the predominant. This is often the case of pedophilia emerging as a symptom of brain insult (i.e. acquired pedophilia). The aim of this research is to identify a behavioral profile that might help clinicians and psychiatric consultants to identify defendants whose pedophilia is more likely to be the consequence of a neurological disorder.Methods: Cluster hierarchical analysis on variables identified through a systematic review of the literature on cases of acquired pedophilia was applied to a new dataset including 66 italian closed cases of pedophilia. Stepwise regression analyses were carried out to further analyze the differences between the clusters identified in the cluster analysis. Results:The sample was partitioned into two large clusters. Individuals with ascertained acquired pedophilia were grouped together. The two clusters widely differed for the prevalence of red flags (2.14±0.79 vs 4.96±0.93, p<0.001). Regression analysis provided a robust model that included the three most significant red flags that, together, explain over 64.5% of the variance (absence of masking, spontaneous confession and offenders older age).Conclusions: An organic origin for pedophilia should be suspected if the red flags are present in a defendant charged with pedophilia: an in depth trans-disciplinary neuroscientific investigation is advocated. The behavioral profile identified might help to provide a proper assessment of defendants and might help judges to reach an informed decision on the defendant mens rea, reducing controversies and avoiding to punish people who need medical treatment.