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Explicit sexual activity, such as sexual penetration, may occur within a session, but is not essential.

This article is about consensual adult sadomasochistic activity.For the medical condition involving non-consensual ideation or behaviour, see Sexual sadism disorder.For the medical condition in which pain/humiliation is required for sexual arousal and causes distress or impairment, see Sexual masochism disorder.Bottom and submissive are widely used for those partner(s) in the relationship or activity who are, respectively, the physically receptive or controlled participants.The interaction between tops and bottoms—where physical or mental control of the bottom is surrendered to the top—is sometimes known as "power exchange", whether in the context of an encounter or a relationship."BDSM" is an umbrella term for certain kinds of erotic behavior between consenting adults.

There are distinct subcultures under this umbrella term.

The fundamental principles for the exercise of BDSM require that it should be performed with the informed consent of all involved parties.

Since the 1980s, many practitioners and organizations have adopted the motto (originally from the statement of purpose of GMSMA—a gay SM activist organization) "safe, sane and consensual", commonly abbreviated as "SSC", which means that everything is based on safe activities, that all participants be of sufficiently sound/sane mind to consent, and that all participants do consent.

They further argue that setting a discrete line between "safe" and "not-safe" activities ideologically denies consenting adults the right to evaluate risks vs rewards for themselves; that some adults will be drawn to certain activities regardless of the risk; and that BDSM play—particularly higher-risk play or edgeplay—should be treated with the same regard as extreme sports, with both respect and the demand that practitioners educate themselves and practice the higher-risk activities to decrease risk.

RACK may be seen as focusing primarily upon awareness and informed consent, rather than accepted safe practices. The consent and compliance for a sadomasochistic situation can be granted only by people who can judge the potential results.

Some BDSM practitioners prefer a code of behavior that differs from "SSC" and is described as "risk-aware consensual kink" (RACK), indicating a preference for a style in which the individual responsibility of the involved parties is emphasized more strongly, with each participant being responsible for his or her own well-being.