Child sexual abuse (CSA) constitutes one of the most severe violations of children's rights and remains a critical public health and criminological concern in Indonesia. Cirebon Regency, with its dense population, socioeconomic heterogeneity, and rapid urbanization, presents a compelling case for longitudinal investigation of CSA prevalence and its associated risk factors. This study aims to (1) map the prevalence trends of child sexual abuse in Cirebon Regency from 2021 to 2025, (2) identify and classify dominant risk factors contributing to CSA incidents, and (3) analyze the institutional response and protection mechanisms available to victims. A mixed-method criminological design was employed, integrating quantitative secondary data analysis from official police and child protection records with qualitative data generated through in-depth interviews, field observations, and document analysis. Results: A total of 312 documented CSA cases were recorded over the five-year period, indicating a 34.7% increase from 2021 to 2024 before a modest 8.2% decline in 2025 following institutional intervention. Key risk factors include intra-familial perpetration (58.3%), digital grooming via social media (31.4%), low parental supervision, poverty, and inadequate sex education. Institutional response capacity remains significantly limited. Conclusions: CSA in Cirebon Regency demonstrates an alarming upward trajectory attributable to structural, familial, and digital risk factors. Multisectoral intervention, regulatory strengthening, and community-based prevention are urgently required.