A methodology to systematically assess the psychosexual consequences of traumatic brain injury was developed and applied to a group of 21 male patients. A majority of the sample reported negative changes in sexual behaviour, including decreased sex drive, erectile function and frequency of intercourse. Common personality changes included depression, reduced self-esteem and a perceived decline in personal sex appeal. However, despite these changes in sexual behaviour, there was evidence that the quality of their marital relationships was preserved. Furthermore, there was no evidence of a relationship between the level of affect and sexual behaviour.