Individuals with obsessive-compulsive disorder (OCD) exhibit a higher prevalence of sexual dysfunction compared to the general population, which significantly impacts their quality of life. This review aims to discuss the key sexual difficulties faced by patients with OCD and to explore a specific subtype of the disorder known as sexual-oriented obsessive-compulsive disorder. A literature review was conducted using the PubMed, Google Scholar, Web of Science, and Cochrane Library databases. Publications focusing on sexual-oriented OCD were then selected for analysis. The sexual nature of the disorder can manifest in both sexual obsessions and sexual compulsions. It is estimated that 20-30% of OCD patients experience persistent, unwanted erotic thoughts, with a significant group consisting of individuals struggling with obsessive doubts about their sexual orientation. In many cases, obsessive thoughts lead to the development of sexual compulsions, and in extreme situations, they may contribute to the onset of compulsive sexual behavior disorder (CSBD). Particularly interesting are reports on the epidemiology of OCD among LGBT individuals, the specific clinical presentation in this population, and the effectiveness of therapeutic approaches used. Incorporating the aspect of sexual functioning into the therapeutic process may improve prognosis and enhance treatment efficacy, thereby serving as an essential component of a comprehensive therapeutic approach.