•PAPSA remains an understudied area of research.•Professionals struggle with its complex and multifaceted nature and the lack of clear definitions guiding intervention.•The meanings that participants associate with PAPSA are strongly related to the characteristics of the peers involved, the type and the severity of the sexual acts and the luck of social discourse on sexuality in young aeges. Child sexual abuse (CSA) has received considerable recent attention from scholars, contributing to prevention and therapeutic intervention services worldwide. However, CSA is still defined as a form of abuse characterized by age and power gaps between victims and perpetrators, despite ample evidence to the contrary. This may explain why preadolescent peer sexual abuse (PAPSA) remains an understudied area of research. PAPSA is generally defined as sexual acts that are developmentally inappropriate and or harmful between children of the same or similar age. The current study was designed to examine educational and therapeutic practitioners’ perceptions of PAPSA and their interactions with children and youth in their care who experienced this form of abuse, specifically focusing on children between the ages of 6–12. Forty in-depth interviews were conducted with practitioners who have encountered PAPSA in their professional lives, using snowball purposeful sampling. The interviews were analyzed using the qualitative thematic analysis method. The results revealed that participants struggled to make meaning and understand the effects of the phenomenon. To make sense of their experiences in encountering PAPSA, they relied on specific contextual elements related to (1) the characteristics of the peers involved, such as age, gender, and personal history; (2) the type and severity of the sexual acts and the effects on the survivors’ lives; and (3) the social discourse on sexuality—in particular, on sexual abuse—within the relevant age group. Relating to each of these contexts helped them to make sense of their experiences. Additionally, the final theme that emerged was the potential of educational and therapeutic environments to become spaces where PAPSA can be addressed in a compassionate way. The discussion emphasizes the complex and multifaceted nature of the PAPSA phenomenon, the lack of clear definitions guiding intervention, and the urgent need to advance theory to promote both prevention and therapeutic intervention efforts.