The anus has a relatively high concentration of nerve endings and can be an erogenous zone, which can make anal intercourse pleasurable if performed properly. The pudendal nerve that branches to supply the external anal sphincter also branches to the dorsal nerve of the clitoris and the dorsal nerve of the penis.

Sigmund Freud's theory of psychosexual development, for example, described an anal stage, hypothesizing that toddlers derive pleasure from retaining and expelling feces. This is the source of the term "anal-retentive" and the derived informal term "anal".

In addition to nerve endings, pleasure from anal intercourse may be aided by the close proximity between the anus and the prostate for males, and vagina, clitoral legs and anal area for females. This is because of indirect stimulation of the prostate and vagina or clitoral legs.For a male insertive partner, the tightness of the anus can be a source of pleasure via the tactile pressure on the penis. Pleasure from the anus can also be achieved through anal masturbation, fingering, facesitting, anilingus, and other penetrative and non-penetrative acts. Anal stretching or fisting is pleasurable for some, but it poses a more serious threat of damage due to the deliberate stretching of the anal and rectal tissues; its injuries include anal sphincter lacerations and rectal and sigmoid colon (rectosigmoid) perforation, which might result in death.Lubricant and condoms are widely regarded as a necessity while performing anal sex as well as a slow and cautious penetration.

Anal intercourse is sometimes referred to as sodomy or buggery, and is considered taboo in a number of legal systems. It has been, and in some jurisdictions continues to be, a crime carrying severe punishment.