Evidence-based prevention and intervention approaches to the problem of sexually harmful behavior among Indian adolescents include a continuum of primary, secondary, and tertiary interventions. Primary prevention is being operationalized through comprehensive sexuality education, mentorship programs for peers, family strengthening programs, and community awareness programs. Secondary prevention aims at the early identification of at-risk individuals through school-based and community screening, and at providing targeted psychosocial support. Tertiary intervention focuses on the use of cognitive-behavioral therapy (CBT), trauma-informed care, vocational rehabilitation, and the use of restorative justice practices. Empirical evidence from Odisha suggests that school-based sexual and reproductive health (SRH) education significantly enhanced the level of knowledge among adolescent girls from 60.1% at the baseline to much higher levels at post intervention (Alekhya et al., Reproductive Health, 20(1), Article 105, 2023). Family-based interventions led to a significant improvement in knowledge but varying outcomes on attitudes and behaviors, reflecting the need for a combination of adolescent–parent programs (Mataraarachchi et al., International Health, 17(5), 617–648, 2025). Peer mentorship interventions also need strong implementation frameworks, standardized curricula, and systematic supervision to ensure consistency of effects (Siddiqui et al., Sexual and Reproductive Health Matters, 28(1), 1–31, 2020). Tertiary interventions which combine CBT with parental engagement and vocational training are shown to have better reductions in recidivism (County Health Rankings & Roadmaps, Cognitive-behavioral therapy for individuals involved in the justice system. University of Wisconsin Population Health Institute, 2024). Multidisciplinary collaboration between educators/social workers/mental health professionals and community organizations is critical to address the structural determinants of sexual harm, but within a cultural context. Effective intervention requires persistent financial resources, workforce training, programs adapted to culture, and commitment to developmental rehabilitation that provides a balance between accountability and opportunity for positive reintegration.