In 1995, the American Medical Association declared sexual abuse a "silent, violent epidemic." Since that declaration, there has been a growing acceptance and awareness of the need for a broader public health approach to preventing sexual violence. However, it is only recently that individuals and organizations are beginning to look at the root causes of sexual violence and how to prevent first time perpetration of sexual violence--preventing sexual abuse before anyone is harmed. This article provides an overview of the shifts in our language, perspective, and policies regarding how we view preventing the perpetration of sexual abuse, and argues that we must adopt and invest in a prevention approach whose goal is to, first and foremost, prevent sexual violence before anyone is harmed.