Priapism may be generally classified into ischemic and non-ischemic forms, the former of which is a urologic emergency with potentially devastating results if not addressed promptly. In this chapter, we describe the causes, evaluation, and various management techniques of both the emergent event as well as prevention of future episodes. New research has helped shed light on the underlying pathology including cellular and molecular signaling dysfunction. We review the importance of a good evaluation, since management relies on accurate classification. We also review stepwise management from the least to more invasive procedures, always prioritizing preservation of healthy corporal tissue if at all possible. While traditional distal and proximal shunting techniques are reviewed, we also describe more contemporary shunting and non-shunting management methods such as the creation of large distal shunts with intracorporal tunneling as well as corporal decompression. Additionally, we review medical adjuncts to surgical procedures and the role of penile prostheses in the acute and post-priapism settings. Medical approaches to recurrent priapism are also discussed. Non-ischemic priapism, which is not a urologic emergency, is also reviewed including evaluation and management.