There has been increasing interest in the treatment of sexual deviation by pharmacological agents in recent years. This is in part the result of the sexually violent predator legislation being found constitutional by the U.S. Supreme Court in Kansas v. Hendricks 1977. In addition there is an acknowledgment that the sexual abuse of children is a public health problem of staggering proportions and progress in dealing with this is crucial. There are pharmacological agents, specifically serotonin reuptake inhibitors, that are familiar drugs to the average psychiatrist that also appear to be effective agents in the treatment of sexual deviation, meaning a role for the average psychiatrist in the treatment of sexual deviation is feasible. The pharmacological agents include antiandrogen and hormonal drugs as well as the serotonin reuptake inhibitors. The modes of actions, and usual methods of prescribing these agents is reviewed in this article. Further a review of some of the research studies is also included as well as some comments about ethical dilemmas. Future directions in research in this important area are also covered.