Cognitive distortions in sex offenders are specific or general beliefs/attitudes that violate commonly accepted norms of rationality that have been shown to be associated with the onset and maintenance of sexual offending. In this article, we describe the major theories that have been formulated to explain the role of distorted cognition in initiating and maintaining sexual offending. We evaluate each theory in light of a set of theory appraisal criteria and the available empirical research. Finally, we conclude by drawing together the results of this theory evaluation process and highlight the major implications for treatment and future research.