The rational choice approach has been widely used to study criminal decisions, but individuals who commit a sex crime have often been excluded from these empirical evaluations due to the assumed irrationality of their crimes. The first part of this chapter reviews the tenets of the rational choice approach in criminology and their validation in a sample of perpetrators, along with their limitations. The second part presents a comprehensive review of decision making models and findings from the fields of behavioral economics, cognitive psychology, and neuroscience, and discusses their contribution to the criminological approach. Notably examined are the developmental aspects of decision making, influence of personality traits and emotional states, development of expertise, and crime benefits of sexual offenses. The chapter closes by proposing an updated rational choice model to better explain sexually coercive decision making.