Aim Pubic hair grooming is a common practice in the United States and coincides with prevalence of grooming‐related injuries. Men who have sex with men (MSM) groom more frequently than men who have sex with women (MSW). We aim to characterize the influence of sexual orientation and sexual role on grooming behavior, injuries, and infections in men in the United States.

Methods We conducted a nationally representative survey of noninstitutionalized adults aged 18–65 residing in the United States. We examined the prevalence and risk factors of injuries and infections that occur as a result of personal grooming.

Results Of the 4,062 men who completed the survey, 3,176 (78.2%) report having sex with only women (MSW), 198 (4.9%) report sex with men (MSM), and 688 (16.9%) report not being sexually active. MSM are more likely to groom (42.5% vs. 29.0%, P < 0.001) and groom more around the anus, scrotum, and penile shaft compared with MSW. MSM receptive partners groom more often (50.9% vs. 26.9%, P = 0.005) and groom more for sex (85.3% vs. 51.9%, P < 0.001) compared with MSM insertive partners. MSM report more injuries to the anus (7.0% vs. 1.0%, P < 0.001), more grooming‐related infections (7.0% vs. 1.0%, P < 0.001) and abscesses (8.8% vs. 2.5%, P = 0.010), as well as lifetime sexually transmitted infections (STIs) (1.65 vs. 1.45, P = 0.038) compared with MSW. More receptive partners report grooming at the time of their STI infection (52.2% vs. 14.3%, P < 0.001) compared with insertive partners.