Ejaculation is a complex event that involves the autonomic, somatic, and central nervous systems working together with physiologic coordination of muscular contractions. With such a complex array of intricate processes, many things can go awry.

Delayed ejaculation (DE) is overall a very poorly understood ejaculatory disorder with low quality data in terms of incidence, pathology, diagnosis, and treatment. In this chapter, we summarize the proper assessment of DE patients and highlight not only the medical conditions contributing to the disorder but also the psychologic ailments. Treatment is outlined based on pathology and an algorithm will be presented for treatment of ejaculatory disorders. With appropriate treatment many of those afflicted will be able to find relief. Nonetheless, ongoing DE research is still needed.