This unstructured review is based on a comprehensive literature search leading to a variety of selected studies that summarize the historical development of paraphilias. Firstly, paraphilias in ancient times are discussed. Secondly, the development of paraphilia diagnoses, including current critical aspects, is outlined. Finally, a short description of the development of treatment approaches for individuals with paraphilic disorders and those who commit sexual offenses, including medical and psychotherapeutic approaches as well as online intervention programs, is presented. The destigmatization of people with deviant sexual interest is deemed necessary. However, it is also recommended to always strive for a balance between protecting paraphilic individuals’ rights and protecting vulnerable groups to whom paraphilic people can pose a danger.