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An empathy-related component has been included in most sex offender treatment programs since the 1980s; however, research linking empathy to sexual offending and/or to treatment outcome has produced mixed findings. This study examined the relationship between victim specific empathy, general empathy, and overall treatment change (determined by responses on a battery of psychometric tests) with static risk (Risk Matrix 2000 [RM 2000]) and sexual offense reconviction data in a sample of 105 offenders who completed treatment while in prison or in the community in England and Wales and followed up for an average period of more than 10 years. Victim-specific empathy improved from pretreatment to posttreatment and related to overall treatment change. A small group of offenders, whose victim empathy scores deteriorated from pretreatment to posttreatment, had higher rates of sexual recidivism …