Juveniles with problematic sexual behaviors are often placed in residential treatment. However, little is known about the effectiveness of such treatments in terms of reducing recidivism or enhancing mental wellbeing. To better understand the impact of residential treatment for these juveniles we conducted a Systematic Review on studies that reported recidivism rates. PRISMA guidelines were followed. 1126 studies were initially identified, with only six meeting the final inclusion criteria. Sexual recidivism rates averaged 5.20% across the six studies, which is similar rates of non-residential treatments. The results suggest that certain client factors predict recidivism, for example youth labeled as obsessive offenders were more likely to recidivate compared to those labeled as opportunistic. Most studies also measured non-sexual crimes post treatment; recidivism rates for sexual misconduct tended to be lower than for other crimes. Despite the significant intrusion of residential treatment centers, remarkably few empirical studies exist to establish their effectiveness in reducing recidivism. The comparable recidivism rates to non-residential treatment programs begs the question of whether residential centers add value beyond outpatient care and suggest that less restrictive interventions may be sufficient. Helping youth evidencing problematic sexual behaviors involves complex dynamics, however caution is recommended on relying on residential treatment.