Child sexual abuse (CSA) and associated psychological distress are known to have a profound negative impact on behavioral patterns of victims. Juveniles incarcerated in correctional institutions are undoubtedly more susceptible to CSA in childhood. In spite of the growing research literature on CSA in the U.S., empirical investigation of CSA among juvenile prisoners in China has been lacking. This study seeks to address this important issue that has largely been overlooked. The data were collected from a juvenile reformatory located in a southern province of China. The findings show that approximately one in five juvenile offenders reported having experienced CSA, a rate that is higher than their same-age counterparts in the population. The reported mental health problem among the CSA victims was found to be more severe than the non-victims in the sample. More importantly, CSA exerted a significant effect on drug-related offense, while psychological distress was a significant predictor of violent offenses. The importance and policy implications of this study are discussed.