In most Western societies sexual offenders are more reviled than almost any other type of offender. On both sides of the Atlantic this is reflected in the sanctions that specifically address this group such as Sexually Violent Predator laws in the United States, Dangerous and Long-Term Offender legislation in Canada, and Sex Offender Orders in the UK. Related approaches include the introduction of sex offender registries and the widespread requirement that children at risk from sexual predators be reported by professionals and others. Although prone to find reasons to delegate the assessment and management of sex offenders to specialized forensic services, the general psychiatrist will find it impossible to avoid them entirely. It is important, therefore, for the general psychiatrist to have some understanding of this area in order to make appropriate decisions and recommendations. This chapter looks at definitions of sexual offending, types of sexual offender, assessment of sex offenders, assessment of risk, treatment issues, and ethical issues.