Sexual violence against children is recognized internationally as the most severe violation of their human rights and the worst form of child abuse and exploitation. It can have severe, long-term and even life-threatening effects on a child’s physical, psychological, spiritual, emotional and social development.1Sexual violence against children is a global problem and in recent years there has been increasing concern throughout Pacific countries regarding the incidence and suffering that children there experience. In 2003, the Inter-Agency Group (United Nations Children’s Fund (UNICEF) Pacific, United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP) and End Child Prostitution, Child Pornography and Trafficking of Children for Sexual Purposes (ECPAT International)) hosted the Pacific Regional Workshop on Combating Poverty and Commercial Sexual Exploitation of Children and Young People in Nadi, Fiji. Workshop participants highlighted a serious lack of information and data on the incidence of sexual abuse and exploitation of children and emphasized the need for baseline data for further action, including further planning and implementation of activities. In response, the Inter-Agency Group initiated studies in five Pacific countries to assess – for the first time ever – the situation of sexual violence against children. This regional report is a synthesis of the findings of each country study – Fiji, Kiribati, Papua New Guinea, Solomon Islands and Vanuatu – which were conducted between October 2004 and June 2005.2 The purpose of this synthesis report is not to single out any one group for ridicule but rather to break the long-running silence surrounding the incidence, extent and nature of sexual abuse and sexual exploitation against children in the Pacific region and to prompt open, constructive community debate and new policies that aim to end the suffering of victims.