In this paper I have attempted to place the concept of the actual neurosis in a new modern perspective. Freud's clinical data as well as my own have been used to bring this neglected and spurned concept into a meaningful relationship with modern research into the physiology of sex. The syndrome of vasocongestion described by Masters and Johnson has many analogies with the actual neurosis known as anxiety neurosis. In reviewing the subject of the actual neuroses, it is clear that no consistent idea about them has been incorporated into analytic theory. There are reality factors which lead to actual neurotic symptoms that are often neglected by the analyst or interpreted solely as manifestations of unconscious conflicts.