Despite its importance for epidemiological and clinical reasons, relatively few studies investigated determinants of bother or distress associated with sexual problems. To assess perception of bother from sexual concerns and examine its role in predicting treatment-seeking. The Brief Sexual Symptom Checklist and two single-item questions were used to assess type of sexual problems, level of bother, and treatment-seeking behavior. Participants were recruited by selecting all sequentially eligible patients in each of the hospital's clinics. The scales used were drawn from the Hospitalized and Outpatients' Profile and Expectations Study survey instrument. Data were analyzed using chi-square, Fisher's exact tests, and multivariate logistic regression models. In total 415 inpatients (48% men and 52% women) participated in the study. A high prevalence of male and female sexual problems was obtained (more than 50%) with a high degree of overlap among the various sexual problems. Common profiles included lack of desire and arousal or orgasmic problems in the women (8–9%); erectile dysfunction (ED) and low desire in the men (21.7%). Forty-five percent and 34% of our male and female participants, respectively, reported moderate or severe bother with its level declining with aging only in women (P<0.001). Degree of bother was strongly associated with ED (P=0.005) and curved penis (P=0.02) in men, and with difficulties reaching orgasm (P=0.01) in women. In both genders, bother increased the likelihood of willingness to discuss the sexual problem with a physician (odds ratio OR 10.66 for men and OR 4.35 for women); only in women, bother was associated with treatment seeking (OR 2.81). Sexual dysfunctions are not always associated with increased bother or dissatisfaction, a condition that influences treatment-seeking behavior. Such findings are of clinical importance as they aid physicians in establishing a diagnosis of a sexual disorder. Evangelia N, Kirana P-S, Chiu G, Link C, Rosen R, and Hatzichristou D. Level of bother and treatment-seeking predictors among male and female in-patients with sexual problems: A hospital-based study. J Sex Med 2010;7:700–711.