Clinicians routinely administer Hare's (2003) Psychopathy Checklist-Revised (PCL-R) to sex offenders and report PCL-R scores as meaningful predictors of recidivism risk. Although a 2005 meta-analysis reported a small (d = 0.29) association between PCL-R scores and sexual recidivism (Hanson & Morton-Bourgon, 2005), no meta-analysis has examined effects for PCL-R factors and facets, the widely cited combination of high PCL-R and high sexual deviance scores, or potential moderators of the PCL-R/recidivism relation. We conducted a meta-analysis of effects from all available studies examining the relation between PCL-R scores and sexual recidivism (k = 20, N = 5,239). The effect for PCL-R Total scores predicting sexual recidivism was d = 0.40, which falls beyond the upper end of the 2005 confidence interval [0.20, 0.38]. Effects were stronger for Factor 2 (d = 0.44) and Facet 4 (d = 0.40) scores than other factor or facet scores (ds = 0.01 to 0.17). Effects tended to be stronger for scores calculated for research (d = 0.44) compared to those calculated for clinical use (d = 0.28). Offenders who scored high on both the PCL-R and a measure of sexual deviance were more likely to reoffend sexually than other offenders (odds ratio = 2.80 to 3.21, k = 6). Results indicate that PCL-R scores, particularly combined with a measure of sexual deviance, are potentially relevant to sex offender risk. But results also underscore several practical challenges to implementing these findings in routine clinical practice. (Contains 3 tables and 4 footnotes.)