The present study examined the validity and reliability of a youth sexual offense risk assessment and treatment planning tool, the Violence Risk Scale-Youth Sexual Offense Version (VRS-YSO), on a sample of 102 court-adjudicated youth referred to assessment and/or treatment outpatient services followed up an average of 11.7 years in the community. VRS-YSO scores demonstrated "good" to "excellent" interrater reliability (intraclass correlation coefficients [ICCs] = .64-.83). Exploratory factor analysis (EFA) of the static and dynamic items identified three latent dimensions consistent with the extant risk literature labeled Sexual Deviance, Antisocial Tendencies, and Family Concerns. VRS-YSO scores showed strong patterns of convergence with scores from the Estimate of Risk for Adolescent Sexual Offense Recidivism (ERASOR), Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II), and the Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (J-SORRAT-II). VRS-YSO scores, in turn, demonstrated moderate to high predictive accuracy for sexual, violent (sexual and nonsexual), and general recidivism (significant areas under curve [AUCs] = .67-.88). Examination of pre-posttreatment change data on the subset of youth who attended treatment services found VRS-YSO change scores to be significantly associated with reductions in general recidivism, but not other recidivism outcomes. Future research and clinical applications of the VRS-YSO in youth sexual offense assessment and treatment planning are discussed.