Millions of children are victims of trafficking and commercial sexual exploitation each year. Governments have responded with a range of measures, focusing primarily on seeking to prosecute perpetrators of these abuses and offering assistance to select victims. These efforts, while important, have done little to reduce the incidence of these forms of child exploitation. This Article asserts that a central reason why efforts to date may not be as effective as hoped is that governments have not oriented their approaches properly toward prioritizing prevention—the ultimate goal—and addressing these problems in a comprehensive and systematic manner. Instead, efforts to date have been piecemeal and oriented toward dealing with exploitation of children after the harm occurs. This Article argues for refocusing efforts toward the development of a comprehensive, prevention-oriented strategy that addresses the root causes of these problems. The Article discusses how certain critical issues—(1) research/data; (2) program design; (3) the dominant principle guiding state responses; (4) stakeholder coordination; and (5) the interrelationship among rights—have been largely ignored in developing responses to child trafficking and commercial sexual exploitation. The Article suggests that, by focusing greater attention on these issues, governments and child advocates can develop more effective responses to the trafficking and commercial sexual exploitation of children, and increase the likelihood that responses to these problems will help prevent such abuse of children.