Australian Cardinal George Pell has been sentenced to six years in prison, with a non-parole period of three years and eight months, for sexually abusing two choirboys.
Pell will be a registered sex offender for life.
Handing out the sentence on Wednesday, Chief Justice Peter Kidd said Pell acted with "physical aggression and venom", the abuse had a "nasty element", and his victims experienced "degradation and humiliation".
"I consider your moral culpability across both episodes to be high," he told Pell.
"I reject the submission of your counsel that the offending in the first episode, or the sexual penetration offence was at, or towards, the lower end of the spectrum of seriousness."
At the same time, Chief Justice Kidd said Pell's age is a key factor in his sentencing, and Pell has been "effectively reformed".
"I am conscious that the term of imprisonment... carries with it a real, as distinct from theoretical, possibility that you may not live to be released from prison," he told Pell.
"Facing jail at your age in these circumstances must be an awful state of affairs for you. You are also clearly someone with some significant enough health issues."
Pell was found guilty on five charges of child sexual offences committed more than two decades ago against 13-year-old boys. He had pleaded not guilty to all five charges.
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The Cardinal's crimes were recounted in detail at a pre-sentence hearing in the County Court in February.
The court heard how he caught two 13-year-old choirboys inside Melbourne's St Patrick's Cathedral drinking sacramental wine in an off-limits room; how he cornered them, told them they were in trouble, exposed his penis, and assaulted them both.
"This offending warrants immediate imprisonment," Crown prosecutor Mark Gibson said at the time. "It involved two vulnerable boys."
But Pell's lawyer Robert Richter asked for leniency, describing his offending as a "plain, vanilla case" of sexual abuse.
Mr Richter presented character references which painted him as "a man who has a great deal of compassion, a man who has a great sense of humour... none of them would believe him capable of this."
One of those references came from former Australian Prime Minister John Howard, and was written after Pell had been convicted.
Pell becomes the most senior Catholic clergyman worldwide to be convicted for child sex offences.
"It's justice being served," sex abuse campaigner Chrissy Foster said. "It's the wheels of justice turning and it's a great day for victims."
But the Holy See has announced it will do nothing until Pell's exhausted his rights of appeal.
"This is painful news that, as we are well aware, has shocked many people, not only in Australia," Vatican spokesperson Alessandro Gisotti said.
"As already expressed on other occasions, we have the utmost respect for the Australian judicial authorities."