ABSTRACT Evidence suggests an increasing involvement of technology and online activities in child sexual abuse (CSA); however, empirical knowledge of the phenomenon is limited. This study investigated the role technology/online activities play in CSA, from the perspectives of healthcare professionals. Fifteen multidisciplinary healthcare professionals specialising in CSA assessment and therapy for children and adolescents completed a semi-structured interview. Results indicate technology and online activities can feature in the facilitation, perpetration, and aftermath of CSA in various ways, presenting unique challenges for victims, caregivers, and involved professionals. A range of complexities were noted in relation to CSA where there is a cyber component (e.g. permanence and reach of CSA images online), and implications for assessment and therapy at the child, parent/guardian, and clinician levels (e.g. tolerating uncertainty regarding images existing online). These findings are summarised in a diagrammatic framework, alongside priorities and prerequisites for addressing the problem of online/technology-assisted CSA.