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Physical disabilities such as a spinal cord injury (SCI) may change the sexual functioning of a person. The aim of this study was to estimate the frequency of sexual dysfunction (SD) in a cohort of Pakistani men with SCI and explore the influence of level and completeness of SCI, financial and educational status, and rural versus urban living on SD. Fifty-nine men with SCI (mean age: 32 ± 9 years) participated in the study. They were asked about sexual desire, sexual intercourse before and after SCI, type of penile erection they could achieve, methods they used to attain erection, attainment of orgasm and ejaculation, and the level of satisfaction with their sexual life. The majority (83.1%) possessed sexual desire but only 22% performed sexual intercourse following injury. Most men (81.4%) were able to achieve erection. The commonest type of erection was reflexogenic (n = 42) and masturbation was the preferred method (n = 35). Only 35.6% were successful in reaching orgasm and 13.6% had effective ejaculation. No one could have children following injury. The largest proportion (n = 20) reported somewhat satisfaction with their post-injury sexual life. Statistical analysis showed that men with incomplete lesions were significantly better in terms of sexual intercourse (p = 0.008) and achieving ejaculation (p = 0.001). Men of younger age were significantly better (p = 0.026) in terms of sexual desire. Educational grade, financial status, urban versus rural living, and the level of SCI did not significantly influence sexual desire, sexual intercourse, reaching orgasm, achieving erection or ejaculation, and satisfaction in sexual life. In conclusion, following SCI, most men in our sample possessed sexual desire and attained penile erection, however, less engaged in sexual intercourse, reaching orgasm, successful ejaculation, or becoming fathers. Individuals with an incomplete injury and younger age seemed more sexually active than those with a complete injury and older age. However, the majority were satisfied with their sexual life. [ABSTRACT FROM AUTHOR]