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This systematic review integrates the empirical evidence of spiritual experiences triggered by sexual activity, including studies by 10 authors. Despite venerable sexual meditative traditions of embodied spiritual practices, such as Hindu Tantra, Vajrayana Buddhism, and Taoism, empirical studies of sexual spiritual experiences are in their infancy. This review presents the range of sexual altered states experiences identified to date and how they qualify as spiritual experiences phenomenologically and in terms of their lifechanging effects. Seventeen distinct sexual-spiritual states have been identified across authors, with 4 others identified at significant levels in qualitative studies by individual authors. As an emergent area of scholarly interest, research on this topic remains scattered across disciplines and is characterized by small studies, many advanced by doctoral students conducting dissertation research. This article integrates the empirical research and situates it in a larger, diverse theoretical, historical, and anecdotal literature, to critically assess consensus on the topic. Deliberate practices, adventitious conditions, human physiology, and other dynamics that conduce to sexual spiritual experiences are discussed.