Sibling sexual abuse (SSA) can have a significant impact on human development and counselors play an important role in identifying, advocating for, and supporting youth who have been sexually abused. In this article, considerations for counselors working with youth who have experienced SSA are discussed. The impacts of SSA on youth development, and challenges that counselors face when working with those affected by SSA are addressed. Counseling interventions that may be useful when counseling those who have experienced SSA are also provided, along with suggestions for future research.