He ordered that Cosby be taken into custody immediately. Cosby, who had removed his pinstriped suit jacket, was escorted out of the courtroom by guards with his hands cuffed in front of him. He held his cane in his right hand.
"It's been a long journey to get here and today justice was served. It has been a long time coming, but it arrived when a convicted felon named William H. Cosby Jr. left the courtroom in handcuffs headed off to state prison for his crimes," Montgomery County District Attorney Kevin Steele said with Constand standing at his side at a press conference following the sentencing.
Judge O'Neill rejected a request from defense attorneys to allow Cosby to be released on bail pending appeals.
O'Neill ordered Cosby to serve the sentence in "total confinement" for "no less than 3 years and no more than 10 years."
"Mr. Cosby, you were convicted of a very serious crime," O'Neill said, adding "that you penetrated Andrea Constand's genitals with your hands without her permission."
O'Neill called Cosby's crime a "planned predation."
The judge noted that Cosby has never shown any remorse and has not sought any kind of psychological counseling.
O'Neill told Constand that her victim impact statement presented to the judge in writing and partly giving in court Monday was a major factor in helping him decide Cosby's sentence.
"I put a high degree of weight on the impact of the victim and her family," O'Neill said.
In a written statement to O'Neill, which was released Tuesday, Constand wrote, "Bill Cosby took my beautiful, healthy young spirit and crushed it. He robbed me of my health and vitality, my open nature, and my trust in myself and others."
Before sentencing Cosby, O'Neill asked defense attorney Joseph Green whether Cosby wanted to make a statement before he is sentenced. Cosby declined.
"This has been a long journey for justice for all of the accusers, particularly for Andrea Constand and her family," said attorney Gloria Allred, who represents 33 women who have accused Cosby of sexual abuse. "This is an important day. Judgment day has come."
Chelan Lasha, who says Cosby drugged and sexually assaulted her in 1986 in a Las Vegas hotel room when she was 17, said she had hoped for a harsher sentence for Cosby.
"But I'm very happy to know that Mr. Cosby will do time in prison, that he's touchable like he touched us," Lasha said after the sentencing hearing.
From VIP to SVP
Earlier Tuesday, Judge O'Neill designated Cosby a "sexually violent predator."
Cosby appeared alert, cooperative and engaged as he answered a series of questions from prosecutor M. Stuart Ryan designed to determine whether he fully comprehended the implications and consequences of the "sexually violent predator" designation.
Pennsylvania state law defines a person with such a designation has "a mental abnormality or personality disorder that makes the person likely to engage in predatory sexually violent offenses." The consequences of such a designation are severe and lifelong.
The designation also means that Cosby will be required by law to register as a sex offender for the rest of his life and be subject to the most stringent requirements a sex offender can incur.
At one point, Cosby interrupted Ryan with a question: "If I went from the city to another city ... even if it's just overnight, do I have to get in touch with the state police?"
Ryan suggested Cosby seek the counsel of his attorneys.
Cosby's lawyers had pleaded with O'Neill Monday not to send the entertainer they described as an 81-year-old, infirmed blind man to prison but rather place him under house arrest.
Steele asked O'Neill to incarcerate Cosby with a maximum sentence of 10 years.
Cosby was convicted in April of drugging and molesting Constand, a former director of operations of women's basketball at Cosby's alma mater Temple University who once considered the comedian a mentor. The assault occurred in 2004 at Cosby's suburban Philadelphia home.
Constand told O'Neill Monday she wanted "justice as the court sees fit."
"Racist and sexist trial"
After Cosby's was taken to a Montgomery County jail for processing before he is transferred to state prison, his spokesman Andrew Wyatt blasted the trial and conviction as "the most racist and sexist trial in the history of the United States."
He said Cosby "is doing great" and "knows that God is watching over him."
"They persecuted Jesus and look what happened," Wyatt said. "I'm not saying Mr. Cosby is Jesus, but we know what this country has done to black men for centuries."
Cosby's wife of 54 years, Camille Cosby, did not attend Tuesday's hearing, but released a statement, saying, "We have now learned that Bill Cosby was denied his right to a fair trial..."