Acute low-flow priapism is a urological emergency characterized by a prolonged, painful erection which should be differentiated from the prolonged erection related to the use of intra-corporal sexual stimulants. Low-flow priapism can have potentially long-term consequences on the ability to achieve a spontaneous erection. Immediate treatment is, therefore, imperative to deal with this problem that is, in essence, a penile compartment syndrome. Autonomic, nitrergic, and hormonal pathways are known to be responsible for normal erections and these may be modulated to relieve abnormal, priapic episodes. Advances in pharmacotherapy have introduced various agents targeting each of these pathways in oral and injectable forms. These treatments have shown varying success in resolving ischemic priapism and helping provide long-term control of stuttering priapism.