Prolonged exposure (PE) was used to treat chronic PTSD secondary to severe developmental trauma in two adolescent male sex offenders referred for residential sex offender treatment. Both youth were treatment resistant prior to initiation of PE and showed evidence of long-standing irritability and depression/anxiety. Clinical observation and treatment outcome data suggest that marked progress was made in reducing PTSD symptoms and improving the youth's overall mood after 16-19 PE sessions. Abatement of PTSD appeared to have a parallel effect on improving the youth's overall investment in his sex offender treatment and his relationship with his therapists. Results suggest that PE is feasible for treating PTSD in juvenile sex offenders, highlight the potential relevance of PTSD intervention in these youth, and help to emphasize the need to conduct more rigorous evaluations (e.g. randomized designs) of the effect of PE in improving sex offender treatment outcomes of trauma exposed youth.