The treatment of sexual offenders is purported to have evolved over the last 40 years, with new models of practice being developed and implemented based variously on theory, research, and policy. Currently, it is recommended that sex offender treatment follow a cognitive-behavioural approach, adhere to the principles of risk, need, and responsivity, and make use of effective therapeutic practices and therapist characteristics. Within this context, clients increase their awareness of factors that contribute to offending and develop skills and strategies to effectively manage risk for recidivism by addressing such areas as general and sexual self-regulation, cognition, and emotion management and altering their cognitive, affective, and behavioural responses in these areas. Despite advances in the provision of sexual offender treatment and some evidence supporting treatment outcome, there are a number of important shortcomings. Indeed, effect sizes for the effectiveness of sexual offender treatment are small, and some methods of intervention currently are not supported by research and thus hold the potential to be ineffective or harmful. In this chapter, the current state of sexual offender treatment is reviewed, with a focus on the shortcomings of both research and intervention practices in an effort to evaluate the current status of sexual offender treatment.