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Paedophilia—a sexual preference for the body scheme of pre-pubescent children—is defined as a disorder within the International Classification of Diseases (ICD) of the World Health Organization as well as within the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association. Contrary to popular belief, not all sex offenders who target children are paedophiles, and not all paedophiles commit sexual offences. But quite obviously paedophilia is an emotionally charged and controversial topic, which might be an explanation for putting it out of focus within the healthcare system. Mental health professionals are mainly (and worldwide) not well trained in terms of assessment methods and intervention techniques available to develop and implement effective policies and practices. This presents an obstacle for prevention, in that proactive strategies to protect children from child sexual abuse and sexual exploitation by online offences, such as the consumption or distribution of child abusive images (so-called child pornography), which emphasises the internationally relevant dimension of the issue. The article will address key concerns and questions in dealing with this clinically relevant population, offer insights into a primary prevention approach developed in Germany, and discuss the situation on a European level.