The study sought to determine whether maltreatment subtypes, family sexuality, and personal characteristics predicted and distinguished child problematic sexual behaviors (PSB) and externalizing problems (EP). Participants were families of 188 children, 6–11 years old, referred by child welfare services in four Quebec districts. Caregivers completed interviews and questionnaires. Results suggested that family environment and maltreatment subtypes had partially different impacts on PSB and EP. When EP and gender were controlled, younger children in a sexualized family environment and those verbally victimized were more likely to exhibit PSB. When PSB and gender were controlled, verbal abuse and neglect emerged as predictors of EP. Potential implications for child PSB research and interventions are discussed. Aggr. Behav. 36:358–370, 2010. © 2010 Wiley-Liss, Inc.