The aim of this study was to investigate group sex offenses with regard to the role of leaders versus followers and to compare both groups on levels of psychopathology, intelligence, and psychosocial and offense-related characteristics. Eighty-nine adolescent group sex offenders (mean age = 14.9, SD = 1.4) referred by the police to the Dutch child protection agency were examined. Psychopathology, intelligence, and psychosocial and offense-related characteristics were assessed by means of standardized instruments, and criminal careers of the participants were ascertained from official judicial records. Although leaders and followers were similar on many characteristics, some remarkable differences were found. During their sexual acts, followers reported using excessive force more frequently than leaders. Furthermore, leaders reported more emotional problems, whereas followers were characterized by higher levels of problems in the social relational domain. As the findings indicate that juvenile group sex offenders constitute a group with specific mental health needs, diagnostic investigation is important to recognize risk factors and (treatable) problems. The absence of some expected differences between leaders and followers could be due to the method of classification or because group offending constitutes a dynamic process without clearly defined roles for individuals.