Hypertriglyceridemia is a well-recognized complication of protease inhibitor therapy, specifically ritonavir. Fibrate derivatives are recommended as first-line therapy for isolated triglyceride elevations, and gemfibrozil has been successful for managing protease inhibitor-induced lipid changes. A 35-year-old man experienced sexual dysfunction 3 weeks after starting gemfibrozil. The temporal relationship and improvement in sexual function after the drug was discontinued suggest that gemfibrozil may have been responsible for his sexual dysfunction.