INTRODUCTION: Existing reports of clitoral dysgenesis are sparse. The few cases reported in the literature are associated with genetic syndromes or midline defects. Women with sexual dysfunction often present to their OB/GYN provider for evaluation. Historically treatment has centered around adjusting medications that can have a negative effect on sexual function, adding medications to enhance sexual function, and assistance with behavioral health or sex therapy. Structural abnormalities or dysgenesis of the clitoris have not previously been described as a causal factor of sexual dysfunction or anorgasmia. METHODS: Two patients, both in their mid-twenties, presented within six months of each other to a single facility with primary anorgasmia and lack of sexual arousal. Initial pelvic exams revealed normal appearing female genitalia. Upon subsequent workup, a more detailed exam of each patient confirmed a well-formed clitoral hood but concern for lack of clitoral gland with no sensory response. Magnetic resonance imaging (MRI) was performed which showed diminutive clitoral crura and bodies which did not converge into a glans. CONCLUSION: This report represents two occurrences of isolated clitoral dysgenesis and highlights a cause of primary orgasmic disorder not previously described. It is important that providers keep this diagnosis on the differential for female sexual dysfunction. An MRI should be considered during evaluation for anorgasmia to evaluate the clitoris especially if no sensory response following direct palpation of the clitoral hood.