Orgasmic anhedonia, a subtype of anhedonia, is defined by the inability to experience pleasure during orgasm despite normal physiological sexual function. This chapter explores the historical evolution, neurobiological mechanisms, psychological correlates, and clinical implications of orgasmic anhedonia. Rooted in disturbances of the brain’s reward system—especially dopaminergic pathways—orgasmic anhedonia often overlaps with psychiatric conditions such as depression and anxiety. The condition may result from complex interactions between genetic, psychological, and environmental factors, including trauma and chronic stress. Comprehensive evaluation involves detailed medical, psychological, and sexual health assessments. Treatment typically includes antidepressants, dopamine-enhancing medications, and evidence-based psychotherapies such as cognitive-behavioral therapy or sex therapy. Attention to relational dynamics and patient-centered care is essential. This chapter emphasizes the importance of an integrated, multidisciplinary approach to restoring pleasure in sexual function and improving overall quality of life for affected individuals.