Most children will engage in sexual behaviors at some time during childhood. These behaviors may be normal but can be confusing and concerning to parents or disruptive or intrusive to others. Knowledge of age-appropriate sexual behaviors that vary with situational and environmental factors can assist the clinician in differentiating normal sexual behaviors from sexual behavior problems. Most situations that involve sexual behaviors in young children do not require child protective services intervention; for behaviors that are age-appropriate and transient, the pediatrician may provide guidance in supervision and monitoring of the behavior. If the behavior is intrusive, hurtful, and/or age-inappropriate, a more comprehensive assessment is warranted. Some children with sexual behavior problems may reside or have resided in homes characterized by inconsistent parenting, violence, abuse, or neglect and may require more immediate intervention and referrals.