Abstract Sexual dysfunction is common in patients with chronic renal failure. This disorder in people with renal failure is multifactorial including physiological as well as psychosocial factors. In addition to the uremic milieu, peripheral neuropathy, autonomie disturbance, peripheral vascular disease, and pharmacologie therapy play a substantial role in the genesis of this condition. The development of therapeutic approaches faces challenges as it is often difficult to determine the primary event(s) responsible for the sexual dysfunction. It is important to consider the therapeutic strategy based on the comprehensive context of the management of various problems presented by each patient with chronic renal failure. Considerations towards the better resolution of the sexual dysfunction in patients with chronic renal failure will be discussed.