Youth problem sexual behaviors (PSBs), and particularly youth illegal sexual behaviors, have deleterious consequences for youth who engage in them, including removal from the home, perpetration of non-sexual offenses, and chronic involvement with the child welfare and juvenile legal systems (Lussier, Juvenile sex offending through a developmental life course criminology perspective: An agenda for policy and research). Further, individuals who are victims of youth PSBs also experience poor mental and physical health outcomes, resulting in a significant public health expenditure (Hailes et al., Long-term outcomes of childhood sexual abuse: An umbrella review). Researchers and policymakers alike have therefore placed considerable focus on efforts to develop effective evidence-based treatments for youth PSBs. To date, randomized controlled trials (RCTs) for interventions targeting PSBs have yielded positive outcomes for both school-age children and adolescents. Despite this, untested practices or practices with limited empirical support (i.e., those unsupported by data from RCTs) predominate service delivery with this vulnerable clinical population. In the present article, we discuss treatment de-implementation models in the context of PSB treatment. Then, we cover two treatment modalities focused on youth illegal sexual behavior specifically and for each describe: (a) the clinical interventions, (b) the available research, and (c) whether they should be considered de-implementation. We conclude with future research directions and practical recommendations for future de-implementation evaluation.