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The commercial sexual exploitation of children (CSEC) is a complex crime with varied trajectories of victimization and perpetration. Historically law enforcement has struggled with CSEC victim identification and case investigations; however, recent research suggests meaningful changes to law enforcement’s engagement in a victim-centered approach. It remains unclear what exact law enforcement practices have changed, and how such practices are being navigated by law enforcement themselves. To address this gap. the current study uses qualitative interviews with 80 professionals across 11 U.S. communities to explore law enforcement’s response to CSEC crimes, with a particular focus on innovative practices related to victim identification and case investigation. All participants took part in a 30–45-minute interview that was digitally recorded and transcribed verbatim. Interviews were analyzed using a grounded theory approach. Findings reveal three distinct themes: (1) Addressing survivors’ hierarchy of needs; (2) Going above and beyond Police duties; and (3) Proactive approaches. The findings underscore that practices are shaped by context, including agency resources and geographic region. The importance of building strong interpersonal relationships and maintaining flexibility in police work with CSEC survivors is also emphasized. These findings, as well as implications for future research and practice, will be discussed.