The aim of this paper is to explore the ways in which the concept of evil has been invoked in relation to child abuse. First, the scene is set by juxtaposing professional discourses which have eschewed the concept of evil and public opinion which is affronted by the evil of child abuse. Second, I will discuss the work of some therapists in the USA whose work with perpetrators and survivors has led them to frame the causes and consequences of child abuse in terms of moral evil. Third, I will draw upon case studies of Satanic abuse and spirit possession in the UK to illustrate that some social workers and religious communities have interpreted child abuse as an outcome of or as an antidote to metaphysical evil. Finally, there is a critical appraisal of the merits of referencing moral and metaphysical evil in the discourses of caring professionals, with a suggestion that a mythical–metaphorical conception of evil could be a more flexible and fruitful resource for therapeutic work.