Male sexual health concerns are often construed in the medical literature as linked only to genital and reproductive difficulties and malfunctions. However, in reality, male sexual health concerns encompass a broader range of issues and should not be so narrowly conceived. This paper explores men's perceptions of sexual health concerns in Muong Khen, a rural town in northwestern Vietnam. Data were collected through observation, in‐depth interviews and focus group discussions. Findings suggest that men's sexual health concerns are strongly related to worries about economic problems, excessive drinking, men's beliefs about how their bodies work and the hegemonic notion that a man should be responsible for his family's economic well‐being.