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Sexual dysfunction is highly prevalent in patients with schizophrenia and other psychotic disorders, which may be because of their symptoms, hospitalization, or psychotropic medications. This could have a negative impact on patients’ quality of life. However, data on this topic are scarce among Egyptian patients.We aimed to evaluate and compare types of sexual dysfunctions in a sample of nonmedicated male patients with first-episode schizophrenia and healthy individuals, and to determine the possible relationships between the sexual dysfunction domains and symptom profile among patients.The study included 50 male patients aged younger than 50 years, admitted to the Inpatient Unit of Psychiatric Department, Cairo University, over a 1-year interval. They were subjected to the following scales: the Mini International Neuropsychiatric Interview, the Positive and Negative Syndrome Scale, the Montgomery–Asberg and a designed questionnaire was also used to collect the patients' sociodemographic data.Male patients with schizophrenia have significantly more sexual dysfunction than healthy controls (56 vs. 6%). There was a statistically significant relationship (P≤0.001) between long duration of untreated psychosis, severity of negative symptoms and depressive symptoms with the severity of sexual dysfunction among patients with schizophrenia.The prevalence of sexual dysfunction in psychotropic drug-naive male patients with first-episode schizophrenia was generally high and would suggest that sexual dysfunction is an integral part of the development of illness and unlikely to be related to the prolactin-increasing properties of the antipsychotic medication. The study also concludes that greater symptom severity in the patient group was associated with greater impairment in sexual function. Therefore, sexual assessment should be a part of every psychiatric examination.