Only a fraction of the perpetrators faced prison and little has been done to punish those who covered up the crimes, though the pedophile priest crisis has cost the US Roman Catholic church nearly three billion dollars.
After years of painful revelations, massive payouts, soul searching and reforms, the child sex abuse scandal has spread across the globe and in recent weeks has struck the church at its very core.
Pope Benedict XVI, long celebrated for speaking out against abuse, faces allegations that he helped to protect predator priests as archbishop of Munich and later as the Vatican's chief morals enforcer.
"We now face the largest institutional crisis in centuries, possibly in church history," the US-based National Catholic Reporter wrote in an editorial demanding "direct answers" from the Holy Father.
The independent newspaper decried the "mismanagement" of the crisis and insisted that "the strategies employed so far -- taking the legal path, obscuring the truth, and doing everything possible to protect perpetrators as well as the church's reputation and treasury -- have failed miserably."
A CBS News poll released Friday showed that more than two thirds of Americans think the pope has done a bad job in handling the crisis. His favorability rating among US Catholics has fallen to 27 percent from 40 percent in 2006.
The allegations currently sweeping across Europe bear a stark similarity to those that first surfaced in the United States in the mid 1980s.
Victims were intimidated into silence. Abusive priests were left unpunished, or shuffled to unsuspecting parishes where they found new prey.
The solutions sought by US bishops are a good model for how the church at large should handle the crisis, said Nicholas Cafardi, a respected canonical law professor and author of "Before Dallas," a history of the clergy child sex abuse crisis.
"We're still in a trust rebuilding process," Cafardi told AFP. "But the only thing that turned that around was the very drastic action the bishops took in 2002."
After years of inaction, the United States Conference of Bishops developed a charter governing how the church would protect children that included a zero tolerance policy, background checks and prevention training.
It also established a National Review Board led by lay people to monitor progress and granted researchers from the John Jay College of Criminal Justice access to church files.
They found that more than 4,392 Catholic priests and deacons sexually abused at least 10,677 American children between 1950 and 2002.
Just 615 of those incidents had been reported to law enforcement and only 384 clergy members were criminally charged, resulting in 252 convictions.
More than 700 priests and deacons were removed from or voluntarily left ministry between January 2002 and December 2003 due to allegations of sexual abuse.
A further 3,091 abusive clergy and 4,568 victims were identified from 2004 through 2009, according to a report published last month.
In a sign of progress, just 30 of the 398 allegations reported last year were perpetrated since 1990.
Six dioceses declared bankruptcy in the wake of massive court settlements and more could follow as more cases work their way through the courts, said John Allen, senior correspondent for the National Catholic Reporter.
"There is considerable debate about whether the church has overcome it or not," Allen said.
"Predictions of a massive implosion (of attendance and donations to) the church didn't come true, so in that sense the church seems to have weathered the storm, but there is significant debate as to how adequate the church's response has been."
While predatory priests have been held accountable, only one American bishop, Cardinal Bernard Law of Boston, lost his job despite evidence of widespread, institutionalized cover-ups, Allen noted.
Church officials also continue to fight attempts to waive the statute of limitation on abuse claims and some bishops refuse to release key church documents or identify the priests who have been defrocked for sexual abuse.
"You still have predators in ministry and they're only being removed from ministry when there is external pressure to get them removed," insists Barbara Blaine, president of the Chicago-based Survivors Network of those Abused by Priests.
"If the pope were sincere, he would be opening up all the records about sex crimes that the CDF (Congregation for the Doctrine of the Faith) is holding and he would turn it over to police."