Over the past two decades our understanding of ejaculatory dysfunction has evolved from the initial premise that these conditions were almost exclusively due psychological factors to a new understanding. We now understand that men with lifelong premature ejaculation may have an underlying genetic predisposition to rapid ejaculation and that men with acquired premature ejaculation may have, in addition to a variety of psychorelational factors including global anxiety, sexual performance anxiety and depression, be also suffering comorbid erectile dysfunction, chronic prostatitis and a variety of less common conditions including hyperthyroidism. Interested parties have observed a paradigm shift in the way we classify, define, evaluate, diagnose and treat ejaculatory disorders. Our understanding of these disorders is not as advanced as is our understanding of other sexual dysfunctions particularly erectile dysfunction. However there is a growing awareness and an increased level of interest from clinicians, scientists and industry parties which promises future major advances in the management of these important disorders.