OBJECTIVE To examine the thoughts and concerns of men contemplating vasectomy before speaking to a physician as well as their partner's role in reaching this decision. METHODS A questionnaire analysis using response rates, ANOVA, and regression analyses. METHODS A large Midwestern teaching hospital. METHODS Visitors to the urology clinic of the hospital. METHODS None. METHODS [1] Questionnaire designed by authors. [2] Measures of self-concept, relationship satisfaction, and problem-solving abilities. RESULTS [1] Subjects had been considering vasectomy for an average of 1 year and were fairly certain of their decision. [2] Anxiety about vasectomy surgery was mostly driven by fear about pain and fear of the unknown. [3] Concerns about the finality of the procedure did not emerge as a big concern. [4] There is confusion about the reversibility of the procedure. [5] Subjects are better problem solvers and have a higher self-concept than people in general. CONCLUSIONS Our findings demonstrate the need for adequate prevasectomy counseling, particularly in the area of postoperative expectations, as well as reversibility of the procedure.