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Phone sex conversation may take many forms, including (but not limited to): guided, sexual sounds, narrated, and enacted suggestions; sexual anecdotes and confessions; candid expression of sexual feelings or love; discussion of very personal and sensitive sexual topics; or just two people listening to each other masturbate.
Phone sex exists both in the context of intimate relationships (e.g., among distanced lovers), and as a commercial transaction between a paying customer and a paid professional.


Workers
A phone sex worker is a type of sex worker and pornographic actor, sometimes referred to as "phone actor", "fantasy artist", "adult phone entertainer", "audio erotic performer", or any one of other monikers. The most valued attributes of a phone sex professional are his or her voice, acting and/or sexual roleplay skills, along with the experienced ability to discern and respond appropriately to a broad spectrum of customer requests.
Contrary to appearances, most phone sex operators do not masturbate during every client session; rather, they may vocally simulate masturbation, sexual intercourse, and/or engage in sexual roleplaying scenarios catering to the particular sexual fetish or request of the client.

Often these requests involve taboo topics that paying customers cannot engage in during real life sexual encounters due to moral and legal ramifications, psychological inhibition, lack of physical ability, unwillingness of a committed partner or the fear of social stigma. Phone sex operators or companies may, by policy or discretion, refuse to entertain certain requests.

Many other services accommodate the extreme taboo market by using signifying phrases in their advertising such as “no taboos” or “no restrictions.” Phone sex and the phone sex worker thus provide a semi-anonymous outlet for such unconventional fantasies without consequence beyond the fee involved in the exchange.
The most obvious purpose of commercial phone sex may seem to be to provide people with a live masturbation aid, but a select clientele relies on phone sex as a vehicle for revealing intimate thoughts and feelings to a neutral stranger. Phone sex patrons are overwhelmingly male, and for many of these men it is important for their confessor to be a woman, especially when their confessions involve BDSM roles, cross-dressing, pegging, infantilism or homosexual fantasies.

It is not uncommon for people to resort to phone sex as an alternative to revealing their secret desires to a therapist, significant other, or friend.
In effect, the phone sex worker is a surrogate called upon to serve in various roles or capacities specific to each client. In certain cases, a patron may not need a confidant for sexual stimulation, but may simply wish to hear another person's voice, or want to fulfill some other need, such as a sense of nurturing, sympathy, camaraderie, or other form of emotional intimacy.
Phone sex services primarily market to men or women of a particular sexual orientation, and focus on mainstream sexual experiences.
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Specialized companies also cater to clients who have a certain sexual predilection (e.g., zoophilia, coprophilia, domination/submission, humiliation) or an erotic interest in a specific group (nurses, firemen, college students, older/younger figures, ethnic minorities, etc.) It is not at all unusual for a phone sex service to employ a staff of phone sex performers to meet both mainstream and exotic customer requests. The panoply of specialized phone sex services available and the vast variety of sexual topics submitted to phone sex workers, reflect the incredibly broad spectrum of human sexual behavior, and are indicative of the general need for a sociosexual outlet which mainstream society often fails to provide.
As a business
Most of today's phone sex services are a managed network of dispatchers (live or automated) and erotic performers who process payment information, verify the legal age of their clients, and perform calls in their own homes on their own telephone lines.

The vast majority of modern services use toll-free numbers whereby clients can dial up to request a call with a particular performer using credit cards, Automated Clearing House systems, and a variety of other billing methods. There are still some services that rely upon premium-rate telephone numbers (e.g.

976 and 900 numbers) for billing purposes, although this practice has been largely abandoned due to the high rate of fraud associated with these lines and the inability to dial 900 and 976 lines from cellular phones. As a direct result, most telephone companies allow their customers to block outgoing calls to premium-rate telephone numbers.

In 1996, the FCC changed regulations on 900 numbers to address abuse of these services by minors and fraud concerns.
Another type of service is the live callback, where the customer contacts a receptionist who tries to find a suitable woman to call him/her back - hence callback.
Like other sex industries, the phone sex industry has taken on new dimensions in the Internet age. There is an ever-growing community of independent phone sex operators who engage in self-promotion.
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This self-promotion can involve a personalized website where the phone sex performer lists their specialties and services, various methods of advertising (via the traditional methods listed below, or on organized third-party network sites that provide a basic level of privacy for performer and client alike) and/or surfing of sexually themed chat rooms for interested clients. This increase in independent operators is largely because information regarding the business is being filtered to the mainstream public.

The once close-lipped industry, traditionally inaccessible to amateurs is experiencing a demystification period and resource sites, community forums, and reference materials are more readily available.
Phone sex service providers typically advertise their services in men's magazines, in pornographic magazines and videos, on late-night cable television, and online. Some phone sex services use state-of-the-art customer acquisition techniques such as active database marketing to reach potential clients.

These advertising methods almost invariably target men, the primary consumers of phone sex services.
In the past it was widely believed that phone sex services engaged in shoddy age and billing verification practices due to that fact that people often complained to telephone and credit card companies they didn't recognize the charges for these adult services. This was especially true when premium-rate telephone numbers were widely utilized by the industry.

However, the reputation as an outlet for fraudulent activity has remained with the phone sex industry (as with other types of sex industry professions), causing many credit card issuers and billing processors to reject or revoke phone sex businesses for merchant accounts, even where no history of fraud exists. This social stigma is furthered by occurrences on record in which public figures have suffered scandal and career damage when their phone sex activities were disclosed.
Several online companies provide Internet-based phone sex lines.
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Nevertheless, phone sex should not be confused with prostitution wherein money is exchanged for real-life sexual services or physical interactions.
In popular culture
Sex Over the Phone by Village People has phone sex as a main theme.
The song "Skandal im Sperrbezirk" by Spider Murphy Gang mentions a situation where prostitution is prohibited within Munich and a phone sex service makes a lot of profit.
The main theme of the song "Sex on the Phone" by the eurodance project E-Rotic has phone sex as primary topic.
The song "Phonography," a bonus track on the Britney Spears album Circus uses phone sex as the main theme.
Singer/comedienne Sandra Bernhard has a song called Phone Sex on her album Excuses for Bad Behavior.
The music video for Sweet Emotion involves a 26-year-old having phone sex with another woman. "What's The Safest and Most Powerful Sex Toy for Valentine's Day? The Phone!".
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