Minimal research has investigated the prevalence of sexual disorders in homosexual men. We examined sexual performance concerns, problems, and satisfaction in a convenience sample of 197 homosexual men who attended a health seminar. Sexual dysfunction and sexual concerns were found to be common problems. Almost all men reported some sexual difficulty over their lifetime, and more than half reported a current sexual difficulty. A further 25 % of the sampled men identified other sexual concerns as well. Despite these figures, most participants—whether single, dating, or in a relationship—reported average to above-average sexual satisfaction. Correlates of sexual satisfaction included more liberal attitudes toward human sexuality, greater comfort with men’s sexual attractions to other men, lower levels of internalized homophobia, and greater satisfaction with one’s relationship status. Painful receptive anal intercourse appeared to be a common, yet previously under acknowledged, difficulty. Almost half of the respondents described HIV/AIDS as having a negative impact on their sexual functioning, with most reporting an increase in fear of sex as the major negative outcome.