Background Recovery from an MI includes adapting to physical changes and invokes psychosocial responses such as anxiety and depression. Patients are anxious to resume their usual activities after an MI, including sexual activity. However, they may be afraid that engaging in sexual activity could lead to further myocardial damage or even death. Although patients tend to show anxiety about resuming sexual activity after myocardial infarction, relevant counseling is often lacking. Aim of the present study was to investigate practices and Greek nurses’ knowledge, comfort, ease, responsibility and practical application of sexual counseling among post-infarction patients. Methods Data were collected by interviews conducted over three days at the 2006 cardiological conference of the Greek nursing association. Five trained researchers carried out the interviews using a 35-item questionnaire Data analysis was performed by using t-test, ANOVA and SPSS statistical package. Results From the sample was 86% female of mean age 37 years old. Although the large majority (84.8%) agreed with the general principle that sexual counseling forms part of nursing care, the practice appeared to be quite different. Only 20.7% said that nurses do in fact undertake sexual counseling and although 39.1% said that they carry it out themselves, most only did so “sometimes”. Less than half of the respondents (42.0%) felt comfortable in discussing the sexual concerns of post-MI patients and only 46.2% felt qualified to handle such a discussion - although rather more (71.5%) claimed that they possessed the technical knowledge about sexuality after MI. Conclusion Sexual counseling is essential to meet the sexual integrity and quality of life needs of the patient and partner after myocardial infarction. Nurses must be trained in the necessary knowledge and skills.