According to the evolutionary theory of psychopathy, male psychopaths will use coercive sex with females of reproductive age as a mating strategy. Thus, psychopathic sex offenders will select victims of reproductive value. An explanation for male sex offenders who select children or male victims is the presence of neurodevelopmental perturbations that account for their non-sexually “fit” victim selection (i.e., deviant sexual arousal). The relevant literature on the relationship among sex offenders, psychopathy, and neurodevelopmental impairments is reviewed with the goal of developing a working theory of sex offending that can discriminate between offenders who sexually assault children and males and those who assault females of reproductive age. The review concludes with the implications such a theory may have on the treatment and management of these offenders and the implications for public policy and prevention.