Sexual pain in men is a multifactorial condition with significant physical and psychosocial consequences. It may present as penile, scrotal, ejaculatory, or erectile pain and can arise from diverse etiologies including vasectomy complications, inguinal hernia, pudendal nerve entrapment, Peyronie’s disease, chronic prostatitis/chronic pelvic pain syndrome, ejaculatory duct obstruction, infections, and dermatologic disorders. Accurate diagnosis relies on a thorough history, physical examination, and selective use of imaging and laboratory tests. Management strategies range from conservative and pharmacologic approaches to surgical interventions, tailored to the underlying cause. Recognition and treatment of sexual pain are essential to improving quality of life and sexual health in affected men.