Juveniles that engage in sexually problematic behavior (SPB) are a heterogeneous population for which a “one size fits all” approach is inadequate. This chapter takes a developmental approach focusing on identifying life experiences in concert with genetic and social factors that alter developmental trajectories. This shift in approach still permits the consideration of risk factors while also allowing for individual traits, personal relationships, social influences, and strength and protective factors to be examined. The chapter delves into the impact of adverse childhood experiences while considering how the environment, experience, and timing affect development. Although various important adverse experiences are identified, it is important to note that no definitive set of experiences reliably determines who will engage in SPB. This chapter explores theoretical explanations that include critical aspects of social learning theory, conditioning, and attachment. Consideration of pathways to SPB includes literature on adolescent limited and high rate/slow desister pathways and the influence of delinquent conduct and sexual deviance. The chapter also discusses the importance of resiliency, parental involvement, and positive attachment experiences on development. Finally, the chapter closes with scientifically based legal and policy applications related to developmental considerations for juvenile SPB.