AbstractBackgroundPeyronie's disease (PD) has a huge impact on patients’ physical and psychological wellbeing.ObjectivesTo investigate whether patients’ age has an impact on PD symptomatic burden at first presentation.Materials and methodsData from 129 consecutive heterosexual patients seeking first medical attention for PD at a single andrological tertiary‐referral centre were collected. All patients completed the International Index for Erectile Function (IIEF) and the PD questionnaire (PDQ). Descriptive statistics were used to compare clinical features between younger (≤40years) and older (>40 years) patients. Multivariable linear model assessed the impact of age, the degree of penile curvature and their impact on PDQ (total scores and its domains), after adjusting for PD duration and IIEF‐erectile function domain scores.ResultsOf 129, 24 (18.6%) patients were ≤40 years old. Young patients presented with a less severe curvature than older patients (median [interquartile ranges] 20° [15–36] vs. 50° [40–80]; p = 0.04). However, younger age was associated with higher psychological and physical symptoms, PDQ‐penile pain and PDQ‐symptom bother scores (Coeff −0.11, −0.21 and −0.17, respectively) (all p < 0.05). Moreover, the greater the degree of curvature, the higher the PDQ–psychological and physical symptoms and the PDQ‐symptom bother scores (Coeff. 0.21 and 0.22, respectively; all p < 0.05).ConclusionAround one in five men seeking first medical help for PD is younger than 40 years at presentation in the real‐life setting. PD‐related distress varies according to patients’ age, with younger men presenting with a greater risk of penile pain and symptom bother despite lower curvature.