Perineal pain is a common and diagnostically challenging clinical presentation in urologic practices, with a broad range of potential etiologies. One potential, yet often underrecognized, cause is partial segmental thrombosis of the corpus cavernosum (PSTCC), a rare urologic condition with limited available descriptions. The exact etiology and pathophysiology remain poorly understood, though associations with trauma and hypercoagulable states have been identified. While patient presentations of perineal pain can be diverse and complex, providers should obtain a detailed history and appropriate imaging to consider PSTCC as part of the differential diagnosis. This review aims to enhance clinical awareness of PSTCC and provide a comprehensive literature review of the treatment options, outcomes, and likely etiology of previously reported cases. We hope to offer providers a concise, evidence-based approach to recognizing and managing PSTCC within the broader context of perineal pain.