A threesome may be one of four types: MMF (male-male-female, consisting of two males and one female), FFM (female-female-male, consisting of two females and one male), all-male, and all-female. Each of these acronyms may be arranged in different manners, suggesting the positions of the participants. For example, an FFM threesome written as FMF suggests that the two female participants do not engage in sexual activity with each other, instead both simply interacting with the male at the same time.

The people involved in a threesome may have any combination of gender and sexual orientation. Each participant may engage in any type of sex act with one or both of the others, such as vaginal, anal, or oral sex—or mutual masturbation. One or more of the participants may engage in autoerotic sexual activity, such as masturbation, possibly without physical contact with the other participants. It is a matter of subjective definition whether participation of a third person without physical contact constitutes a threesome. This may relate to fetishes such as voyeurism or cuckolding. Lucky Pierre is slang for a person performing both receptive and penetrative anal or vaginal sex simultaneously during a threesome, being positioned between the two partners

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