Working with children who have experienced child sexual abuse (CSA) may have a negative impact on a clinician's wellbeing. However, there is some evidence to indicate CSA work may also result in positive outcomes for the clinician. This study aimed to explore the positive and negative outcomes for clinicians working with CSA. Eighteen clinicians working across a range of services in Ireland and the United Kingdom participated in this study. All were involved in the management of CSA, and their ages ranged between 31 and 53 years (mean = 41.9 years). Participants were recruited through an opt-in regime following a targeted advertisement and email campaign. Semi-structured interviews were completed to explore clinicians' perceived experiences of the positive and negative outcomes of CSA work. Data was analysed using thematic analysis. The thematic analysis developed four themes and four subthemes. The first two were ‘Protecting the Clinician’ and ‘Fulfilment from CSA Work’, which identified participants' subjective understanding of what systemic supports and personal actions maintain their psychological and physical wellbeing. The third and fourth themes, ‘Intrapersonal Disruption’ and ‘The Multiple Challenges of CSA Work’, described the difficulties of working with CSA and the negative impact it can have for clinicians. Findings highlight the importance of supporting clinicians to develop protective strategies to manage the negative impact of CSA work while also acknowledging the positive outcomes, notably a sense of fulfilment associated with working in this specialist area.