PURPOSE OF REVIEW: To define the link between metabolic syndrome (MetS) and sexual dysfunction. The global epidemic of obesity and diabetes has led to a striking increase in the number of people afflicted with the MetS. The MetS consists of a myriad of abnormalities, including central obesity, glucose intolerance, dyslipidemia, and hypertension. RECENT FINDINGS: Although interest in the MetS initially arose due to its association with cardiovascular disease, subsequent data emerged pointing to a relationship with male sexual dysfunction. SUMMARY: Few randomized studies exist to guide treatment of sexual dysfunction related to MetS; rather, most studies have been observational in nature. Medical therapy has formed the mainstay of treatment.