In recent years, the use of public health approaches to address complex social problems has gained popularity. In England and Wales, the rise in low-volume, high-harm crime has accelerated this shift, with calls for public health interventions to tackle knife-crime, extremism and sexual violence made by politicians, policy-makers, welfare workers and the police service. Notwithstanding such appeals, how public health approaches are both operationalised and impact remain largely unknown. Drawing on findings from a qualitative study focused on the implementation of a specific initiative in the UK designed to reduce the risk of Child Sexual Exploitation (CSE) amongst young people, this article attempts to address tangible gaps in these two key areas of knowledge. Although generally supportive of a public health approach to CSE, an analysis of in-depth interviews with members of a multi-agency team reveals a number of quandaries and thorny issues when implemented within a specific policing and criminal justice context.