Background: Primary headache associated with sexual activity is a rare type of headache mostly seen in male gender and initiates at the 3rd decade. Even though the pathophysiology is still unknown, it is a benign type of headache and must be reminded on the differential diagnosis of the secondary headache. Materials&Methods: Thirteen patients diagnosed as primary headache associated with sexual activity were evaluated by their clinical and demographic data. Results:Ten male and three female patients were evaluated. The mean age was 37.07± 7.67. Headache was usually localized at bilateral occipital area or diffuse, starting with a severe ache and sudden explosive intensity in association with preorgasm in 8 patients and orgasm in 5 patients with a mean VAS score of 7.8±1.2. The mean duration was 21.53± 15.32 minutes. Five of the patients had a history of migraine, 3 had arteriel hypertension and two were diagnosed as primary thunderclap headache with sudden beginning and high intensity ache. Conclusion: Herein we presented our cases to highlight the importance of differential diagnosis. Patients may have difficulty of explaining the problem therefore their sexual activity could be limited.Apart from pharmacological prevention, counselling and facilitation plays important role in managing.