Two single men, one with compressive spondylitic cervical myelopathy and another with tethered cord and intraspinal lipoma, experienced severe paroxysmal ice picklike pains, solely referred to the neck in the first and to the groin and genitalia in the second, that were precipitated by masturbation and masturbatory orgasms. Continuous, but less intense, background pain was reported by both patients over the same anatomic areas. Neither had intracranial lesions, epilepsy, or suffered from migraine. Recently, extratrigeminal ice pick status was reported in this journal. These two unusual cases represent examples of extracephalic ice picklike pain triggered by sexual activity, in the absence of orgasmic cephalgia.