Rectal resection may impact the sexual function of both men and women. Postoperative sexual dysfunction occurs in as many as 60% of patients, depending upon the specific symptom studied. Studying the issue is complex because the underlying disease process, surgical technique, need for a stoma, adjuvant therapy, and preoperative sexual function all affect postoperative sexual function. The quality of the literature is limited by the lack of studies in which the authors use validated instruments. Even in that context, information on female patients is more limited than data on male patients. Improvements in surgical technique may help reduce postoperative sexual dysfunction while more complete information would improve patient counseling.