One quarter of sexual offenses in the criminal justice system are committed by children and adolescents. Mental health conditions, trauma history, and relationship to the victim may play a role in sexually acting out behaviors (SAB). A retroactive chart review was performed to discover commonalities among 109 adolescent males with SAB admitted to a residential treatment facility. Variables of interest included prior mental health diagnoses, trauma history, full scale intelligence quotient (IQ), relationship to the victim, sex of victim, history of multiple offenses, and history of sexually acting out on an individual aged ≤4 years. Results indicated that 70.6% of the sample had a diagnosis of attention-deficit/hyperactivity disorder, 24.7% had a full scale IQ <90, 41.3% had sexually acted out on more than one victim, and 22.9% sexually acted out solely on males. Pearson's chi-square analysis indicated a non-significant relationship between diagnostic groups and victim characteristics. [Journal of Psychosocial Nursing and Mental Health Services, 60(9), 29-36.].