Spinal cord injury is known to have a major impact on human sexual function. The disturbances depend on the level and completeness of the lesion. The majority of people affected by spinal cord injury are young and in their reproductive years. In these cases sexuality reflects an important aspect of personality, and therefore special attention needs to be given to this issue during rehabilitation. Sexual rehabilitation encompasses both comprehensive information and consultation as well as diagnosis and treatment of disturbed sexual functions. Successful rehabilitation and integration depend also on restoration of sexual function or adequate therapy of sexual dysfunction. This review will consider the present knowledge about the impact of spinal cord injury on female and male sexual function, the currently available treatment options as well as the aspects of fertility and reproduction in this patient population.