Background Routine sexual history taking is an important component of psychiatric case formulation, and while sexual health problems are common, they are often left underdiagnosed in clinical practice. This study aimed to identify Egyptian mental health professionals’ knowledge, skills, and attitudes toward sexual medicine and psychosexual history taking. In this cross-sectional online survey study, 242 mental health professionals (160 psychiatrists and 82 psychologists) currently practicing in Egypt completed the survey. Results About 98.3% of surveyed professionals were in agreement that collecting sexual history is vital to efficient clinical assessments. However, nearly half the participants believed that they lacked sufficient knowledge (51.7%) or clinical experience (50%) in psychosexual health matters, and one-third (34.7%) did not believe that they are confident in managing such problems. More than half (56.4%) do not routinely initiate taking sexual history, and about one-fifth (20.6%) were not comfortable initiating such questions. Common barriers included inadequate education and training (49.2%), irrelevance to patient’s chief complaint (39.7%), limited time (38%) and privacy (34.7%), worry of offending the patient (28.5%), feeling of awkwardness (27.3%), lack of confidence (24%), and to a lesser extent, poor rapport (15.3%) and fear of being judged by the patients (10.3%). Conclusion Egyptian mental health professionals do not routinely discuss sexual health issues with their patients, despite understanding its importance, due to multiple social, educational, and personal barriers. Perceived lack of knowledge, limited clinical experience, personal difficulties, and social constraints are considered the main barriers.