This paper examines sentencing and treatment practices for juvenile sex offenders in Australia and the challenges of reconciling the imperatives of rehabilitation, accountability and community protection. It begins with an overview of juvenile offenders and the juvenile justice system, including the principles for sentencing young offenders. It then considers the complex lives and offending patterns of juvenile sex offenders, before providing examples of judicial reasoning in sentencing. It concludes by examining best practice in treatment for sexually abusive behaviours and innovative justice responses to juvenile sex offending, such as therapeutic treatment orders and restorative justice conferencing.