Introduction As a result of advances in surgical techniques and (neo)adjuvant therapy, mortality rates for colorectal cancer (CRC) have declined significantly in the last two decades. In general, CRC survivors report good health-related quality of life in survivorship. However, many survivors, including those who describe their quality of life as good, also report sexual problems that persist long after treatment is completed. Aims In this article, we review the effects of different treatment modalities for CRC on sexual functioning in men and women. We highlight both the physical and psychological aspects of CRC treatment and discuss the management of common sexual problems in CRC survivors. Methods The authors reviewed the existing available published articles regarding this topic. Results Our review of the evidence suggests that surgical treatment and (neo)adjuvant therapy for CRC are commonly associated with a wide range of sexual problems. Conclusions Sexual functioning is an important functional outcome after CRC treatment and is influenced by a myriad of clinical and patient factors, including an individual's physical and psychological well-being after a diagnosis of CRC. As such, the assessment and management of sexual functioning in men and women with CRC should begin prior to the initiation of treatment and continue throughout treatment and survivorship. Breukink SO and Donovan KA. Physical and psychological effects of treatment on sexual functioning in colorectal cancer survivors. J Sex Med 2013; 10(suppl 1): 74-83.