Twenty-six patients with signs and symptoms of ejaculatory dysfunction (hemospermia, hypospermia, oligospermia, or painful ejaculation) were examined with high-resolution MR imaging with an endorectal surface coil. Findings were abnormal in 15 patients. Abnormalities detected included four cases of müllerian cysts, three cases of wolffian cysts, one case of anaplastic prostatic carcinoma, and various noncystic abnormalities of the seminal vesicles and ejaculatory ducts, including ejaculatory duct obstruction and seminal vesiculitis. In all cases, depiction of both the normal and abnormal anatomy of the entire seminal tract, including the vas deferens, seminal vesicles, and ejaculatory ducts, was excellent. This depiction of the detailed anatomy of the prostatic cysts made it possible to suggest specific diagnoses. Our results show the value of MR imaging with an endorectal surface coil in the examination of patients with ejaculatory dysfunction.