Evidence concerning the psychological effects of vasectomy for American men was reviewed. Surveys of postoperative sexual behavior, satisfaction, and/or happiness suggest that the effects of vasectomy are generally positive. Data from studies employing clinical interviews and/or psychological tests, however, support a very different conclusion. These investigations which are generally superior in methodology and measurement techniques to the survey studies indicate that (a) although men in general verbally express satisfaction with vasectomy, many men are probably describing feelings which have been distorted as part of an attempt to cope with their private concerns about the consequences of the operation; and (b) many men experience some difficulty in adjusting to the psychological consequences of vasectomy. Implications for future research are discussed.