Sex offending is a major public health concern due to the potentially serious consequences for the victims (especially in case of rape or paedophilia). All care providers agree that imprisonment alone does not solve the question of repeat offences for these subjects and that a combined medical, psychological and social approach is needed for these offenders. A combination of psychotherapy (especially behavioral therapy) with pharmacological treatment is better than one or other therapy used alone. Two types of medication are used for these subjects; serotonergic antidepressants and antiandrogen treatments. Two antiandrogen treatments have obtained Health Agency approval in different European countries in this indication: cyproterone acetate and depot triptorelin (3-month formulation). Guidelines have been published in France by the National Health Authority and, at the international level, by the World Federation of Societies of Biological Psychiatry (www.wfsbp.org/). In this paper, we will define the term paraphilia and report some epidemiological data, before summarizing the available literature about the efficacy of pharmacological treatment for paraphilias.