Ejaculation is a highly integrated process that involves both the sympathetic and parasympathetic neural pathways. Numerous studies reveal that ejaculatory dysfunction is a common disorder and the source of significant bother for many of those affected. Ejaculatory dysfunction comprises several different, more specific abnormalities including: premature ejaculation, inhibited ejaculation (consisting of delayed and absent ejaculation), and painful ejaculation. The evaluation of affected patients should include a comprehensive medical history, physical examination, and laboratory testing. Numerous therapeutic options are available to treat ejaculatory disorders, with many of these leading to marked improvement in patients’ symptoms and associated bother.