Koro has been found to exist mainly in Asia and Africa. Some authors describe the syndrome as a universal syndrome, rather than a condition found only in certain cultures. It is not uncommon to find koro presenting with comorbid conditions and psychopathology relevant to these conditions. The cases in this article illustrate three different presentations of Koro in Sri Lanka, where the affected males believed that their worth was associated with fertility and sexual potency. One patient had comorbid schizophrenia, and other two had anxious personality traits.