[Abstract] Objective To compare the clinical efficacy of different doses of sertraline in the treatment of primary premature ejaculation. Methods Eighty-six patients who met the diagnosis of primary premature ejaculation were selected, and the International Erectile Function Rating Scale and the Chinese Sexual Function Evaluation Scale for Patients with Premature Ejaculation were assessed before treatment. After 4 weeks, the patients were divided into 3 groups according to the efficacy and adverse effects to enter the second phase of treatment for 4 weeks: those who were effective and had no or mild adverse effects continued the treatment; those who were ineffective but had no significant adverse effects, the dose of sertraline was adjusted to 100 mg daily; those who were effective but had significant adverse effects, the dose of sertraline was adjusted to 25 mg daily; and those who were ineffective and had significant adverse effects, the dose of sertraline was adjusted to 25 mg daily. 25 mg; those who were ineffective and had significant adverse reactions and could not tolerate the treatment were withdrawn from observation. After 4 weeks of treatment in the first phase of 86 cases, 63 cases (73.3%) were effective and 23 cases (26.7%) were ineffective. Among them, there were 53 cases (61.6%) without obvious adverse reactions and 33 cases (38.4%) with adverse reactions. In the second phase of treatment, 35 cases with no significant adverse reactions and 12 cases with minor adverse reactions in the effective group continued the original treatment, and the sertraline dose was adjusted to 25 mg per day in 16 cases with significant adverse reactions and could not be tolerated. After 8 weeks of treatment, 47 cases in the 50 mg group were effective with no obvious adverse reactions; 10 cases in the 25 mg group were effective, 6 cases were ineffective, 2 cases had minor adverse reactions and were tolerated; 8 cases (44.4%) in the 100 mg group were effective. 13 cases (72.2%) had adverse reactions but were tolerated, z cases withdrew from treatment due to obvious adverse reactions, and 1 case was ineffective with no obvious adverse reactions. The incidence rate was 21.0% (17/81). Conclusion Sertraline was safe and effective in the treatment of primary premature ejaculation, and there was no significant change in the efficiency of individualized treatment regimen. The incidence of adverse reactions was significantly reduced, and patient compliance with treatment increased.