One of the most influential theories in the field of sexual aggression is Pithers’ Relapse Prevention Model (RPM) (Pithers, Marques, Gibat, & Marlatt, 1983; Pithers, 1990), inspired by Marlatt’s conceptualization of the relapse process in individuals with an addiction. Pithers’ model details the sequence of cognitions, emotions, and behaviors culminating in sexual aggression. In addition to a sequential model, the authors propose self-management methods specifically designed to prevent sexual recidivism following treatment. However, this chapter will exclusively focus on Pithers’ model of the offending process. Following a description of Marlatt’s conceptualization, we will outline the core features of Pithers’ adaptation of it for sexual aggressors. The results of studies designed to evaluate the validity of the RPM for sexual aggressors will then be presented, and critical issues related to the RPM discussed.