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Subpubic cartilaginous cysts (SCCs) are rare.This is the first reported case of a male patient presenting with neurological and sexual symptoms due to an SCC.We describe the clinical history of a patient who reported neuralgic pain, numbness in the groin and base of his penis, and loss of sexual function.A magnetic resonance imaging revealed the presence of an SCC with associated mass effect. A conservative approach was adopted and within 12 months, the cyst had decreased in size and his symptoms had improved.Men who present with erectile dysfunction and neurological symptoms merit a thorough assessment including appropriate investigation to exclude organic pathology. Wylie KR, Griffiths J, Pye J, Salim F, and Inman R. A subpubic cartilaginous cyst causing neurological and sexual symptoms in a 69-year-old man. J Sex Med **;**:**–**.