Background: Premature ejaculation (PE) is a sexual debilitating condition affecting a large number of men worldwide, influencing the patients' affective and emotional life. Hyaluronic acid (HA) is a natural and safe compound that has been widely used not only in the aesthetic medicine clinic but also for the treatment of osteoarthritis.  Objective: To show the effectiveness of a HA-based procedure for treatment of PE.  Patients and methods: A total of 20 male patients were treated with HA injections in the deep dermis of their glans penis to increase the volume and the circumference of their penis to prevent male PE and improve the patients' and their partners' sexual satisfaction.  Results: At 6-month follow-up, intravaginal latency time was still significantly higher when compared with baseline values. The maximal glandular circumference was significantly increased at 6-month follow-up. At baseline, patients' self-rated satisfaction with sexual intercourse was 1.5±0.07, and partners' self-rated satisfaction with sexual intercourse was 1.48±0.06. At 6-month follow-up, patients' self-rated satisfaction with sexual intercourse was 6.2±0.08, and partners' self-rated satisfaction with sexual intercourse was 5.5±0.07. The procedure is well tolerated without adverse reactions.  Conclusion: HA injection is a promising treatment for PE.