Background: Tramadol is a weak opioid analgesic, which is generally considered to be safe with huge potentials of misuse. This study aims to assess the effect of tramadol in patients with long-term tramadol abuse regarding sexual function. Methods: The participants of the study were recruited from Federal Neuropsychiatric Hospital Kware, Sokoto State, Nigeria. 50 individuals with a history of tramadol abuse were included. They were assessed clinically, sexuality scale, and sexual quality of life questionnaire-male version. They were compared with a control group of 48 individuals with no history of drug abuse. Results: All the aspects of quality of sexual life were significantly better in the control group than the tramadol abuse group. Conclusion: Individual with tramadol misuse are more likely to experience poor quality of sexual life compared to healthy controls.