INTRODUCTION: Sexual dysfunction is common among depressed male patients; however, its causes are complex and multifactorial. The aim of this study is to identify risk factors for sexual dysfunction associated with depression. METHODS: One hundred and twenty-five consecutive depressed male patients were interviewed at Jeddah Psychiatric Hospital. They were divided in to two groups, on the basis of whether they had sexual dysfunction or not. These two groups were then compared on a number of potential risk factors, using chi-square and odds ratio. RESULTS: The majority of patients had not previously been asked about sexual dysfunction. Seventy-seven (62%) presented with sexual dysfunction and 48 (38%) without. Marital difficulties, hypertension, diabetes, severity of depression and tricyclic antidepressants were significant risk factors. No association was found with demographic origin, occupation, education or marital status. These results are similar in some aspects to those reported in western studies. CONCLUSIONS: (a) The majority of doctors do not take a sexual history despite its high prevalence, (b) Physical illness and overall severity of depression were important risk factors.