Narcissism has long been associated with diminished sexual and overall relationship satisfaction, but this association has not been investigated in the larger context of sexual function/dysfunction, also known to affect these outcome variables. Using a multivariate approach, this study investigated the relationships among sexual narcissism, sexual function/dysfunction, and sexual and overall relationship satisfaction in 1297 men completing an online survey about sexual history, sexual health, sexual function/dysfunction, and narcissism. Results indicated widespread differences on various sexual parameters between narcissistic and non-narcissistic men, with narcissistic men showing higher sexualization overall as well as higher auto-erotic orientation. Higher sexual narcissism was also significantly associated with various symptoms of sexual impairment, including a propensity toward both premature ejaculatory response and delayed ejaculatory response. Despite this association, both sexual narcissism and sexual function/dysfunction scores also independently predicted sexual and overall relationship satisfaction. Discussion focuses in part on explaining how two diametrically opposed sexual problems—rapid ejaculation and delayed/inhibited ejaculation—might play out sequentially in the sexual relationships of narcissistic men.