Sarno, a pioneer of the sexploitation film genre, completed his first adult-oriented feature, Nude in Charcoal, in 1961. Among his best-known films in the genre are Sin in the Suburbs (1964, which was about wife swapping), Flesh and Lace, The Swap and How They Made It (1966, in which his wife appeared), and Moonlighting Wives (1966). Sarno's work of the sexploitation period was typified by stark chiaroscuro lighting, long takes, and rigorous staging. He was also well known for scenarios centering on issues of psycho-sexual anxiety and sexual identity development.