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Premature ejaculation (PE) is a common male-type sexual dysfunction. According to DSM-IV criteria PE is defined as, persistent or recurrent ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it. Various drugs and sexual therapies are used in the treatment of PE. The most widely drugs used are topical analgesics and SSRIs. Paroxetine is the most effective SSRI for prolonging the ejaculation time. Despite its strong effect, recurrence is observed very quickly right after termination of treatment. Here we discuss a premature ejaculation case, who doesn’t accept sexual therapy. However benefited from oral paroxetine treatment but suffered premature ejaculation symptoms after cease of treatment. A 35-year-old, male patient, who was an employee, graduated from primary school. He has been married for seven years and has a child. He applied our clinic for sudden and uncontrolled ejaculation during intercourse . He married after a 6 years period of engagement, since his first sexual intercourse ejaculation time was less than 1 minute. The frequency of sexual intercourse was biweekly and foreplay time was 5 minutes. After the assessment, we suggested sexual therapy for this patient. His wife refused sexual therapy and he started 20 mg oral paroxetine treatment. After two months the patient had 40% subjective improvement in his ejaculation time and was asked to continue oral paroxetine treatment. He observed an ejaculation time of 1-2 minutes. In first application his Arizona Sexual Experience Scale score was 15, Glombock Rust Inventory of Sexual Satisfaction raw score was 45, premature ejaculation subscale score was 13 out of 16, and satisfaction subscale score was 12 out of 16. After two months of oral paroxetine treatment his Arizona Sexual Experience Scale score was 15, Glombock Rust Inventory of Sexual Satisfaction raw score was 34, premature ejaculation subscale score was 13, satisfaction subscale score was 12. 1 month after drug cessation ejaculation time was less than 1 minute. Paroxetine is a quick and available option in premature ejaculation treatment. Although paroxetine is an effective way of extending ejaculation time, 3 weeks after the drug release premature ejaculation symptoms come back with the rate of 90%. In this case Glombock Rust Inventory of Sexual Satisfaction raw score was better when the premature ejaculation symptoms improved, but there was no improvement in premature ejaculation, satisfaction subscores and Arizona sexual experience scale score. These findings may point that this improvement was symptomatic and not permanent. For this reason premature ejaculation treatment studies that evaluate long term effects of pharmacotherapy could be beneficial.