Objective: We present the case of an adult man complaining of orgasmic anhedonia. The patient who has no health problems or psychic diseases, doesn’t smoke and is immune of biological risk factors. Andrological physical, biochemical and instrumental investigation shows no evidence of organic cause. The man who is forty five, is married, has two children and is able to copulate twice a week, with his attractive wife. We have two objectives: 1 to uncover the cause of the patient’s sexual complaint and 2 to give him the possibility to profit of his erectile capacity and fully enjoy sexuality. Design and Method: After a complete sexual anamnesis, we invite the patient to describe in detail his sexual activity and behavior, his attitude and feeling towards sex and sexuality. We investigate his autoerotic and sexual fantasies and focus our attention on the continuity-discontinuity of his sexual reality and imaginary. Results: The clinical investigation, conducted with empathy and respectful of the patient’s difficulties, let gradually emerge a controversial sexual scenario. Our first objective is reached. The patient has now the possibility to solve his symptom, negotiating with its reasons or to continue to live with it. Conclusions: Lack of sexual pleasure or male orgasmic anhedonia can be expression of an unmanageable or dystonic erotization and not of a functional inability. Sexologist can help patients to clarify by themselves the nature of their symptoms and to decide about the suitability of their resolution.