Insecure attachment has been associated with short-term mating strategies and higher numbers of extra-dyadic affairs. Research has found that insecure attachment is also related to sexual addiction. A sample of people seeking treatment for sexual addiction (N = 4,492) was used to explore the prevalence of attachment styles in such a population, and the degree to which insecure attachment predicts relationship preoccupation, and preoccupation with isolated sexual pursuits, both measured by the SDI-4.0 Preoccupation scales. Preoccupied and fearful avoidant attachment were the most prevalent attachment styles in this sample. Results found that anxious attachment was better than avoidant attachment in predicting relationship preoccupation and isolated fantasizing in both men and women, while avoidant attachment was a statistically significant predictor of relationship preoccupation, but more strongly predicted isolated sexual behaviors. In structural equation models women's sexual cycling behaviors were better predicted by anxious attachment, whereas men's sexual cycling behaviors were equally related to anxious and avoidant attachment. Anxious attachment was a better predictor of men's sexual aversion, but in women aversion was better predicted by avoidant attachment. The relevance of these findings for clinical applications is discussed.