Throughout the two-day enforcement action, officers targeted offenders across Musselburgh, Prestonpans, Tranent, Haddington, Dunbar and North Berwick.
The four men – aged 23, 31, 43 and 56 – have been charged for sexual offences including public indecency and sexual assault.
Officers also detained a further ten people in connection with eight assaults, which took place earlier this year.
Eight men between the ages of 20 and 49 were later charged along with two women aged 35 and 42.
Police also executed drugs warrants at addresses in Prestonpans and Haddington where quantities of heroin, cocaine, diazepam, cannabis and cash worth £10,000 were recovered.
The extensive activity was carried out as part of the ongoing Operation Fusion initiative, which is being led by officers in East Lothian.
Various pieces of intelligence were also gathered throughout the two days of action and will be progressed by officers.
Chief Inspector Matt Paden said: “Operation Fusion is our ongoing initiative to tackle a range of different crimes taking place across East Lothian and our latest enforcement phase has resulted in numerous arrests and a great recovery of drugs and cash.
“The success of these operations is based on the information we receive from our local communities and I would urge anyone who knows of ongoing criminal activity in their area to come forward.
“I can assure you that we investigate all reports of crime seriously and your information could result in another Operation Fusion campaign in the future.”