Sexual dysfunctions had been reported to be more in posttraumatic stress disorder (PTSD) patients than the general population. Until now, a case with spontaneous ejaculation coexisting with PTSD has not been reported. A case with spontaneous ejaculation concurrent to the exacerbation of PTSD symptoms was mentioned in this report. A 25 years old, single man was admitted to psychiatric polyclinic because of PTSD symptoms, and concurrently spontaneous ejaculations began after a traumatic event. He was diagnosed PTSD after the clinical interviews. Organic pathology was not detected to explain spontaneous ejaculations. Paroxetine treatment was begun and decreases in PTSD symptoms, frequency of spontaneous ejaculations were observed in the clinical follow-up. In this case, adrenergic activation system might have been increased with anxiety symptoms specific to PTSD and this increase might lead to spontaneous ejaculation without a sexual stimulus. The reducing effect of the paroxetine on the frequency of spontaneous ejaculation was evaluated to occur through the controlling of the PTSD symptoms and side effects on ejaculation (Figure 1). Assay of metabolites in plasma, cerebrospinal şuid, corporal catecholamines and unchanged serotonin should help to enlighten the underlying neurophysiology of sexual dysfunctions in PTSD patients. Making the treatment choice considering both PTSD symptoms and autonomic instability would increase the benefit out of the treatment in PTSD patients with sexual dysfunctions.