In this chapter, current literature on clergy sexual abuse is reviewed, with a focus on how abuse trends can inform the management of sexually abusive clergy. General trends of clergy sexual abuse—victim choice, abuse patterns, and characteristics of abusive clergy as well as potential explanations for clergy sexual abuse from these patterns are provided. Findings on clinical assessment with sexually abusive clergy are reviewed, including the application of various psychological and sexual risk assessment instruments. Prominent treatment modalities to address how sexual offending may be clinically applied to address sexual abuse by clergy is also provided. In all, sexually abusive clergy appear to be a heterogenous group with many different patterns of victimization and abuse, but evidence suggests clergy sexual abuse is more often motivated by psychosexual deficits, emotional deficits, and opportunity than by paraphilic desires. Existing assessment measures are likely to be less effective and valid with clergy. Encouragingly, though, the Risk-Need-Responsivity Model, Good Lives Model, and Situational Crime Prevention strategies of sexual abuse prevention appear applicable as intervention approaches for clergy sexual abuse.