Scholars have investigated the Japanese tradition of male-male love that arose in the context of the secular and commercial culture of the early modern era. Less often noted is the role of male-male sexuality within a religious framework. This article sheds light on the unexplored religious dimension of medieval Japanese male-male sexuality through an analysis of Ijiri Matakurō Tadasuke's Nyakudō no kanjinchō (1482) and its Muromachi variant. Both works glorify male-male sexual acts and endorse their proper practice. I suggest that Kanjinchō attempts to perpetuate power relations that maintain the superiority of adult monks over young acolytes. Kanjinchō achieves this through constructing its own cosmology, built on a Buddhist cosmogony, soteriology, a pantheon of divinities and ethical norms, which, in effect, endows homoeroticism with sacrality. My analysis of Kanjinchō provides a nuanced understanding of male-male sexuality in Japanese Buddhism and the ideological context in which the text is embedded. Scholars have investigated the Japanese tradition of male-male love that arose in the context of the secular and commercial culture of the early modern era. Less often noted is the role of male-male sexuality within a religious framework. This article sheds light on the unexplored religious dimension of medieval Japanese male-male sexuality through an analysis of Ijiri Matakurō Tadasuke's Nyakudō no kanjinchō (1482) and its Muromachi variant. Both works glorify male-male sexual acts and endorse their proper practice. I suggest that Kanjinchō attempts to perpetuate power relations that maintain the superiority of adult monks over young acolytes. Kanjinchō achieves this through constructing its own cosmology, built on a Buddhist cosmogony, soteriology, a pantheon of divinities and ethical norms, which, in effect, endows homoeroticism with sacrality. My analysis of Kanjinchō provides a nuanced understanding of male-male sexuality in Japanese Buddhism and the ideological context in which the text is embedded.