The current review explores the complex paths that can lead to adolescent and young adult males becoming sexually abusive. Because sexual abuse is an ongoing issue in our society that is often oversimplified, this article distinguishes between the various risk factors that predict sexually abusive behavior and types of sex offenders, particularly recidivistic offenders. It is imperative to focus on adolescents and young adults who sexually abuse because they represent a particularly important intervention point in preventing sexual abuse in comparison to older age groups and address the importance of differentiating among youths who sexually abuse, particularly between one-time offenders and recidivistic offenders. Implications for addressing these differences are discussed.