Despite the widespread incidence of childhood sexual abuse, there is insufficient investigation into the childhood sexual history of perpetrators. In addition, there is little published on the specific similarities between childhood and adult sexual histories. The present study investigates the incidence of childhood sexual abuse in a carefully characterized sample of male pedophiles compared with a demographically similar control group. Concordance between and cognitive distortions about characteristics of childhood abuse and pedophilic behavior are also studied. Twenty men with pedophilia, heterosexual type were compared with 24 demographically similar, healthy male control subjects on a questionnaire specifically designed to assess childhood sexual history in pedophiles. Sixty percent of pedophiles compared with 4% of control subjects reported adult sexual advances as a child. Seventy-five percent of pedophiles and 22% of control subjects reported a first sexual encounter before age 14 years. About 60% concordance was found between acts experienced as a child and perpetrated as an adult. Finally, numerous inconsistencies throughout the questionnaire add preliminary support for the role of cognitive distortions with regard to childhood and adult sexual history. The present findings replicate the elevated rate of childhood sexual abuse found among pedophiles and are consistent with the notion of a causative relationship between early childhood abuse and later pedophilic behavior.