This chapter examines several major aspects of child sexual abuse and explains the leading issues involving child sexual abuse. It describes the acts that are needed to legally constitute child sexual abuse; and the various types of intrafamilial sexual abuse. The chapter aims to distinguish between intrafamilial and extrafamilial child sexual abuse. Child sexual abuse is sexual exploitation or sexual activities with a child under circumstances that indicate that the child’s health or welfare is harmed or threatened. Intrafamilial sexual abuse includes incest and refers to any type of exploitative sexual contact occurring between relatives. Child sexual abuse is one of the most emotional topics in the field of family violence. Repeated media stories report incidents of both long-term and situational sexual abuse of children by family members, caretakers, or strangers. The reason that non-sexual behavioral symptoms are lower probability indicators of sexual abuse is because they can also be indicators of other types of trauma.