Erectile dysfunction is common after surgery for rectal cancer with a prevalence of moderate to severe erectile dysfunction up to 35%. Preservation of sexual function is regarded as a core outcome in colorectal surgery. We wanted to investigate male patients' perspectives on preoperative education about the risk of erectile dysfunction after surgery for rectal cancer. Using an interview guide, we performed individual semi-structured interviews with male patients who had surgery for rectal cancer within the past 3-12 months. The interviews were transcribed, condensed, coded, and analyzed with inductive qualitative content analysis. We interviewed 13 male patients. Their perspectives were condensed in four main themes: importance of a partner to be present at the preoperative counseling; information as crucial; wishful thinking as a coping strategy; and the need for direct information to avoid unrealistic expectations. Patients described general gratitude across the entire process but a lack of follow-up regarding erectile function. Surgeons should actively engage in a discussion with patients regarding the risk of developing erectile dysfunction. Importance might differ since patients have different preoperative erectile functions and different postoperative needs. A partner or close relative should participate in the preoperative counseling.