Introduction Effect of sexual activity on health has long been a debated topic with focus on cardiovascular system. Patients with heart disease often have fear of coital sudden death or triggering a cardiac event, which actually lower their quality of life. Physiological and clinical aspects of sexual function have been extensively studied in patients who have angina, have experienced a myocardial infarction (1-5), have undergone coronary artery bypass graft surgery (6) or heart transplant (7) and those with chronic heart failure (8). A better understanding of cardiovascular effects of sexual activity may help clinicians to identify strategies for prevention and offer valuable suggestion. This article reviews literature on various epidemiological, observational, randomized trials and self-reported surveys during the last five decades.