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Introduction: The pharmacological treatment of sexual offenders - and of those predisposing to these behaviors - aims to inhibit or reduce sexual arousal and recidivism. Pharmacological approaches are not widely used for all patients and are often selected for paraphilias or specific patterns of sexual arousal. Objectives: We aim to present the most common pharmacological treatment options used in clinical pratice for sexual offenders. Methods: A selective literature review was conducted using the PubMed and ResearchGate databases, using the following key words "sexual offenders", "pharmacological intervention", "pharmacological treatment", "paraphilia treatment". Results: Hormonal agents (antiandrogens) target a reduction in testosterone and sexual drive. Research shows that antiandrogens treatment presents lower rates of detected sexual recidivism and decreased sexual arousal in response to offense specific stimuli. Both side effects and negative/punitive connotations of these drugs make them reserved for paraphilic and high risk patients. SSRI are mostly used in cases where there is marked sexual rumination or preoccupation, a compulsive aspect to the sexual behavior or an association with low mood. Their efficacy is the result of a reduction in the intensity of sexual rumination/urges, enhancement of mood, decreased impulsivity, lessening of libido, sexual anhedonia or a combination of these. Although commonly causing loss of libido and erectile difficulties, the antipshychotics' impact is inconsistent and unreliable. Research doesn't provide the evidence for using mood stabilizers, anxiolytics or naltrexone. Conclusions: Due to the lack of studies and the evanescing interest in studying perpetrators, current evidence is far more supporting than robust making the need for guidelines a pressing matter. [ABSTRACT FROM AUTHOR]