Dyspareunia is painful sexual intercourse due to medical or psychological causes. The symptoms are significantly more common in women than in men. The pain can primarily be on the external surface of the genitalia or deeper in the pelvis upon deep pressure against the cervix. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain. There are numerous physical, psychological, and social/relationship causes that can contribute to pain during sexual encounters. Commonly multiple underlying causes contribute to the pain. The pain can be acquired or congenital. A careful physical examination and medical history are always indicated with such complaints. Treatment is determined by the underlying causes. Many women experience relief when physical causes are identified and treated. Even when the pain can be reproduced during a physical examination, the possible role of psychological factors in either causing or maintaining the pain must be acknowledged and dealt with in treatment. Internationally dyspareunia has been estimated to affect between 8-21% of women sometime in their lives.