Hematospermia, the term used to describe the presence of blood in the semen, is an uncommon condition. While it is usually alarming to individuals, the condition typically resolves spontaneously. The cause is almost always benign (non-cancerous) and often no clear cause can be identified, which can make it a challenging condition. It can manifest as a single episode or recur over the course of weeks to months. Known causes include, but are not limited to, following radiation treatment for prostate cancer, sexually transmitted diseases, and bleeding from blood thinners. In individuals over 40 with hematospermia, genitourinary cancers (i.e. prostate, seminal vesicles) should be considered, but the rate of such cancers is low, even after long-term follow-up.