Purpose of Review: We review the evidence base for men who categorically deny responsibility for their sexual crimes. Specifically, we consider the characteristics of these individuals and the purpose or function of the denial, whether denial leads to an increased risk of reoffending and the evidence for different treatment options available for deniers. Recent Findings: Whilst there is some evidence that deniers differ from admitters, it appears that categorical denial is a strategy used to reduce negative consequences such as a sense of shame or the fear of losing family support. The common assumption that deniers are more likely to commit further sexual crimes is not supported by the evidence to date. There remains a lack of evidence as to the best treatment approach to use. Summary: We conclude that more research is necessary. We suggest that a lack of consideration of the function of denial or the adaptive benefits of denial could explain inconsistent findings in relation to the characteristics of deniers and why denial does not appear related to recidivism. Whilst the available evidence does not support most approaches aimed at overcoming denial, we suggest that some of the most promising approaches seem to be non-disclosure-based focusing on reducing stigma; however, it is conceded that the evidence for such approaches is still emerging.