Visual sexual stimuli (VSS) are often used to induce affective responses in experimental research, but can also be useful in the assessment and treatment of sexual disorders (e.g., sexual arousal dysfunctions, paraphilic disorders, compulsive sexual behaviors). This systematic literature review of standardized sets containing VSS was conducted by searching electronic databases (PsycINFO, PubMed, Scopus, Web of Science) from January 1999 to December 2022 for specific keywords [("picture set" OR "picture database" OR "video set" OR "video database" OR "visual set" OR "visual database") AND ("erotic stimuli" OR "sexual stimuli" OR "explicit erotic stimuli" OR "explicit sexual stimuli")]. Selected sets were narratively summarized according to VSS (modality, duration, explicitness, shown sexes, sexual practices, physical properties, emotion models, affective ratings) and participants’ characteristics (gender, sexual orientation and sexual preferences, cultural and ethnic diversity). Among the 20 sets included, researchers can select from ~ 1,390 VSS (85.6% images, 14.4% videos). Most sets contain VSS of opposite- and some of same-sex couples, but rarely display diverse sexual practices. Although sexual orientation and preferences strongly influence the evaluation of VSS, little consideration of both factors has been given. There was little representation of historically underrepresented cultural and ethnic groups. Therefore, our review suggests limitations and room for improvement related to the representation of gender, sexual orientation, sexual preferences, and especially cultural and ethnic diversity. Perceived shortcomings in experimental research using VSS are highlighted, and recommendations are discussed for representative stimuli for conducting and evaluating sexual affective responses in laboratory and clinical contexts while increasing the replicability of such findings.