This article explores erotic countertransference in psychiatry, from its psychoanalytic origins to its ethical and clinical implications today. Despite its prevalence, discussion in dealing with erotic countertransference remains limited, and psychiatrists are overrepresented in sexual misconduct cases. The article reviews historical cases, current data, and theoretical insights, and proposes a structured approach to risk mitigation through improved training, supervision, and clearer professional boundaries. Greater awareness and discussion are needed to safeguard both patients and clinicians.