Sexual dysfuction is a frequent complaint of chronic back pain patients and should be addressed for their complete rehabilitation. A review of the literature suggests that about two-thirds of all back pain patients report sexual problems after pain onset. Several aspects of sexual functioning may be affected, including the frequency and quality of sexual activity. A multitude of factors may be associated with the sexual dysfunction; however, no one factor appears to be more critical in the development or maintenance of sexual dysfunction in chronic back pain patients. Research and clinical issues in the assessment and treatment of sexual dysfunction in chronic back pain patients are discussed.