This article presents a historical overview of research on sexually abusive youth. The evolution of the field over the past 30 years is discussed--from the initial development of treatment interventions to contemporary efforts of professionals to move from traditional, adult-oriented interventions toward developmentally sensitive assessment strategies and practice models. Focus is on two critical areas: risk assessment and trauma-informed care. The article reviews contemporary research on risk assessment tools, stressing the need for validated tools that can accurately assess youth and follow changes in risk over time. Etiological models for understanding effects of trauma (Trauma Outcome Process Assessment and Family Lovemap) are presented. Discussed are new ecologically based therapy models for working with sexually abusive youth that approach the youth holistically and are attuned to youths' needs, including providing interventions to address effects of past trauma.