Polygraph examinations are commonly used to monitor individuals following conviction for a sexual offense. The objective of polygraph use is to elicit risk-relevant disclosures to inform and improve management of people who have offended sexually, with the ultimate aim of reducing the likelihood of reoffending. However, by synthesizing and evaluating the existing recidivism literature relating to post-conviction sexual offense-related testing (PCSOT), this narrative analysis demonstrates that use of PCSOT lacks robust empirical support beyond the fact that examinations facilitate increased disclosures and can be used as a surveillance tool. This review proposes mechanisms through which polygraphs would be expected to impact offending behavior and explores potential explanations for why PCSOT has not been found to reduce recidivism. It is suggested that polygraphs may undermine a trusting relationship and may be over-relied upon as a tool to tackle denial or determine risk categorization, instead of translating disclosures into individualized management. It is clear from this review that there is an urgent need for more rigorous research to assess the effectiveness of PCSOT in terms of treatment and recidivism outcomes, to inform policies that facilitate empirically driven clinical practice.