Sexual behavior problems (SBP) have been increasingly recognized in young children. Despite rising awareness, previous research has focused on school-age children with SBP and adolescent sex offenders. The purpose of the current study was to investigate the history, adjustment, and social environment of preschool children with SBP. Thirty-seven young children with SBP were evaluated. As expected, significant emotional and behavior problems were evident, and caregivers reported high levels of stress related to parenting. Contrary to findings among school-age samples, more of the children were female (65%) than male (35%). Many (62%) did not have substantiated histories of sexual abuse. Many children had experienced physical abuse (47%) and/or witnessed interparental violence (58%). Only four (11%) had no known history of sexual abuse, physical abuse, or witnessing domestic violence. Although further research is necessary, results supported the need to consider the developmentally unique presentation of young children with SBP.