The Royal Commission into Institutional Responses to Child Sexual Abuse in Australia noted that child sexual exploitation (CSE) was a significant issue of concern for children and young people in residential care, as increasing rates of sexual abuse and exploitation are continually reported. Employing a systematic scoping methodology, this review examined the scope and breadth of literature focusing on children and young people living in residential care in Australia who have experienced sexual exploitation. Findings indicate that peer to peer sexual re-victimisation is a serious concern in residential care. Entrapment in this kind of abuse is associated with a downward spiral of ‘pain-based’, complex behaviours, which in turn may render young people in residential care to be at even greater risk. Although prevention program responses are emerging, they remain constrained by the secretive nature of CSE and wider systemic issues. As such, a central recommendation emerging from this review is the need for a proactive and consistent approach to data collection and analysis of CSE in residential care settings. This will enable a comprehensive analysis of the aetiology of the problem, enabling the development of prevention responses to match the identified problem.