This paper reports on a Nuffield Foundation-funded qualitative research project into sexual abuse and sexual offending against elderly people, undertaken with cooperation from HM Prison Service, the National Probation Directorate and two social services departments. This is an under-researched subject in the UK and the objective of this study was to contribute to the knowledge base which informs the development of both policy and practice in protecting vulnerable elderly people from sexual abuse and offending. The paper presents findings relating to the abusers/offenders and their victims, discussing the types of abuse, the circumstances, and the relationships between perpetrator and abused. It reports on the impact of the sexual assaults on the elderly victims, referring both to the immediate aftermath of the physical violence and humiliation and to longer-term effects. There is discussion of recurring themes which emerged in relation to the motivations and characteristics of the perpetrators, including evidence that some were motivated primarily by sexual gratification.