Abnormalities concerning sexual and reproductive function in uremic patients have been documented. Sexual dysfunction and infertility in chronic renal failure are particularly evident in male patients. It was observed that the fertility and potency of men on maintenance dialysis was much less than that in the age matched normal controls. Males with renal failure have a more pronounced incidence of sexual malfunction than females. They have decreased libido, decreased frequency of intercourse, impotence, gynaecomatsia, impaired spermatogenesis, testicular atrophy, infertility and retrograde ejaculation. About 80% of men on maintenance dialysis have reduced libido and erectile insufficiency. In clinical practice, the attention given to sexual problems in patients with end stage renal disease is low. The high prevalence of chronic renal failure, its associated sexual dysfunction, and the controversy about its improvement after renal transplantation were the main motives behind writing the following review.