Primary absolute anorgasmia is the impossibility to have orgasm and ejaculation during wake or every kind of sexual activity, in men with normal erectile function and nocturnal emission. In this syndrome the nervous system is unimpaired; the frequency is very low, with a very small number of reported cases in literature. Andrologists are generally requested by the patients for the first clinical approach. They should collaborate with sexologists for the diagnosis and treatment. Personal experience in 3 cases of anejaculatory men aged between 28 and 34, observed in the years 1995-1996, is presented and the clinical features of the patients and therapeutic strategy described. In two cases a sexual behavioral therapy was performed with success; in the third an electrovibration was employed to obtain the first orgasmic sensation.