This paper reports the results of a critical review of empirical evidence relating to the aetiology of child sexual abuse (CSA) published over the last 15 years. The current review found that the psychology, criminal history and prior victimisation of the perpetrator and the gender, disability status, sexuality and family circumstances of the victim are important risk factors for CSA. Offence characteristics such as the offender‐victim relationship, modus operandi of the perpetrator and absence of a capable guardian are also found to be important markers of risk. We make suggestions for future research frameworks and designs, and we discuss the implications of the evidence for future primary prevention initiatives, practice and policy. We use this evidence to make recommendations for the development of child maltreatment theory more generally.