The present study examined the association of juvenile psychopathy features and treatment response in a sample of 102 youth, court adjudicated for sexual offenses and followed up more than 11 years in the community. The Psychopathy Checklist: Youth Version (PCL: YV) was rated from comprehensive archival sources, along with a youth sexual offense risk assessment and treatment planning measure scored pre-and posttreatment. The PCL: YV converged with domains of sexual offense risk and change in conceptually meaningful ways, and significantly predicted nonsexual violent, general violent, and any recidivism; it did not significantly predict sexual recidivism. Higher levels of psychopathy-related personality features were significantly associated with noncompletion of youth sexual offense-specific treatment, while changes in risk were associated with decreased recidivism controlling for PCL: YV score and baseline risk at p < .10. The findings underscore the importance of intervention and support services for youth convicted of sexual offenses as well as the clinical and risk relevance of the juvenile psychopathy construct to decrease violent victimization to others.