Recent research suggests that sexual recidivism rates have been declining, which contrasts with observations regarding general recidivism rates as well as perceptions of sexual reoffending risk. If sexual recidivism rates are in decline, it raises fundamental policy questions about the youth justice system’s tendency to operate on the assumption that juvenile sexual offending is a risk marker for sexual reoffending in adulthood. A systematic review and a quantitative meta-analysis were conducted to determine the general, violent, and sexual recidivism rates of adolescent perpetrators of sexual offenses with data stemming from studies published worldwide between 1940 and 2019. A total of 158 empirical studies including 30,396 adolescent perpetrators of sexual offenses were retrieved to examine estimates of general, violent, and sexual recidivism. The study findings highlight that the risk of general recidivism (weighted pooled mean = .44) is substantially higher than violent (weighted pooled mean = .18) and sexual recidivism (weighted pooled mean = .08). The study did not observe convincing evidence that sexual recidivism rates for adolescent perpetrators are declining, but rather that these rates have been consistently low over the years. There was strong evidence that multiple study characteristics moderate the recidivism rates observed. Given the low weighted pooled sexual recidivism rate reported in the study, the use of adult-like strategies to increase public safety and prevent sexual recidivism seems misguided, not only because sexual recidivism is unlikely, but also because such strategies are not developed to address general criminogenic needs that may explain general recidivism rates observed.