There is a signiﬁ cant literature on assessing and managing risk in sexual offenders. Much has been written about aetiology (Ward, Polaschek and Beech, 2005), risk factors (Hanson and Morton-Bourgon, 2005, 2009), risk assessment instruments (Beech, Craig and Browne, 2009), treatment (Marshall, et al., 2006; Siegert, et al., 2007) and risk management (Siegert, et al., 2007). There are probably more instruments for sex offenders than any other offender group. Most sex offenders in the community in the UK are managed by probation services (or criminal justice social work services in Scotland) and the police. A signiﬁ cant minority are clinically complex with severe personality disorders and paraphilias providing particular challenges. Community forensic mental health services focus on severe mental illness and provide little input for these conditions. Risk assessment instruments used by criminal justice agencies and standard approaches to community management may be insufﬁ cient to properly manage these cases. Over the last four years, we have developed a service model for providing clinical input to help criminal justice agencies manage sexual offenders with personality disorders and paraphilias in South East Scotland. We present this model in this chapter to illustrate a practical approach to delivering evidence-based clinical risk management in a multi-agency community context with challenging and complex sexual offenders.