The aim of this study was to evaluate the main predictive factors of male sexual desire, considering medical, psychological, and relationship factors. The study assessed 205 men from the general population on the following variables: psychological adjustment, dysfunctional sexual beliefs, automatic thoughts and emotions during sexual activity, dyadic adjustment, and the presence of medical conditions. Regarding cognitive and emotional factors, restrictive attitudes toward sexuality (β = -.27), lack of erotic thoughts during sexual activity (β = -.35), concerns about erection (β = -.26), emotions of sadness (β = -.23), and shame (β = -.23) in a sexual context were significant predictors of sexual desire. Dyadic adjustment and the presence of medical conditions were not significant predictors of male sexual desire. A multiple regression analysis including all these variables, in addition to age, indicated that lack of erotic thoughts during sexual activity was the only significant predictor of sexual desire (β = -.28). These findings suggest the importance of cognitive dimensions in sexual desire, particularly the role of attentional focus and lack of erotic thoughts during sexual activity.