The role of pain-related fear in the etiology and/or maintenance of superficial dyspareunia is still unclear. The objective of this experiment was to investigate the effects of pain-related fear on sexual arousal in women with superficial dyspareunia (n=48) and women without sexual complaints (n=48). To induce pain-related fear, participants were told that they had a 60% chance of receiving painful stimuli while being exposed to one of two erotic film clips. Genital arousal was assessed using vaginal photoplethysmography. Self-reported ratings of genital sensations and affect were collected after both erotic stimulus presentations. Elevated levels of skin conductance and higher ratings of experienced threat during the pain threat condition indicated that fear was successfully elicited. Pain-related fear impeded genital arousal in all women. Women of both groups reported significantly less positive affect and more negative affect when threatened. Although women with dyspareunia did not differ in their genital responsiveness from women without sexual complaints, they experienced overall significantly more negative affect than the control group. The present results indicate that pain-related fear reduces genital and subjective sexual responding in women with and without sexual problems. We conclude that emotional appraisal of the sexual situation determines genital responsiveness in both sexually dysfunctional and functional women.