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Recent research has shown that sexual recidivism rates are relatively low and have been dropping in Canada and the US since the 1970s (Lussier et al., 2023a; 2023b). Although the phenomenon has been observed in both countries, the sexual recidivism drop has been more pronounced in Canadian studies (-60% variation) compared to the US (-40% variation). Most of the research, however, is based on a relatively short follow-up period (e.g., about 5 years). It is unclear whether the sexual recidivism drop is also observed in prospective longitudinal studies with a post-release long-follow period (15 years or more). Using data from a systematic review and quantitative meta-analysis of 468 studies, the current study investigates sexual recidivism rates and trends for long-term follow-up periods. Recidivism rates were examined through a series of sensitivity analyses while statistically controlling for important study moderators (e.g., country, region, sample, study period, length of the follow-up period, offenders’ age). Meta-regression analyses were conducted to examine sexual recidivism trends accounting various study details including possible variations between the US and Canada. Findings will be discussed in terms of criminal justice policies and their impact for risk assessment practices.