Self-mutilation is self-inflicted and intentional damage done to one’s body or one’s body parts without a conscious suicidal intention. The first case of genital self-mutilation was published in 1846, and the first scientific description of genital self-mutilation was written by Stroch in 1901. Since the first case has been described, there have been a relatively small number of described cases of genital self-mutilation in both genders; there have been an even smaller number of cases of repeated genital self-mutilation and only a few descriptions of repetitive forms of male genital self-mutilation in the literature. The aim of our study is to present difficulties in preventing repeated male genital self-mutilation of a patient with an intellectual disability who was diagnosed and treated for epilepsy and psychosis in early adult life and had a previous history of self-destructive behaviour during childhood. Previous literature does not contain many repeated cases of male genital self-mutilation. After evaluating the contribution of each individual factor in the aetiology of self-mutilation, we concluded that every individual factor is significant in the aetiology of self-mutilation; however, no single factor, as well as all the factors put together, is not enough for prevention of self-mutilation. Our conclusion is that all the presented factors in our research (intellectual disability, epilepsy, psychosis, self-destructive tendencies in childhood) have their place in the aetiology of male genital self-mutilation, but none of them are determining factors. This confirms that it is necessary to conduct further research in the field of aetiology of male genital self-mutilation, which would contribute towards more adequate prevention.