Self-related processing, reflecting the evaluation of environmental signals with regard to personal relevance, is fundamental for decision-making and subsequent behavioral responses. While self-related processing has already been investigated in several domains, one important domain, the sexual domain, has been spared so far. Recent imaging studies suggest that self-related processing in different domains involves common regions in medial orbitofrontal and prefrontal cortex, the so-called ventral cortical midline structures (CMS). However, the same regions have also been implicated in sexual arousal, especially with regard to emotional processing in sexual arousal. Therefore it remains unclear whether this involvement of ventral cortical midline regions reflects emotional processing in sexual arousal or associated self-relatedness. We here report data from a parametric event-related fMRI study that investigated the neural correlates of self-related processing in sexual arousal, using erotic pictures from the International Affective Picture System. It was found that self-related activity associated with sexual arousal showed neural activity in ventral CMS regions such as the venteromedial prefrontal cortex (VMPFC) and the perigenual anterior cingulate cortex (PACC), while self-related activity not associated with sexual arousal showed neural activity in the dorsomedial prefrontal cortex (DMPFC). Our study indicates that self-relatedness may be considered a crucial component in sexual arousal that is mediated by neural activity in ventral cortical midline structures.