Sexuality is an integral part of human life and influences the way an individual forms relationships, interacts with others and expresses their emotions. It is a significant determinant of relationship health and quality of life (Clayton and Ramamurthy, 2008). Sexuality is impacted in a myriad of ways following brain injury. This chapter explores the effects of traumatic brain injury (TBI) and stroke on sexuality and ways of addressing these. Whilst the focus is on these two groups the concepts and recommendations apply to anyone with an acquired brain injury (ABI).