Erectile dysfunction (ED) is that the commonest sexual problem in men. The incidence increases with age and affects up to at least one third of men throughout their lives. It causes a considerable negative impact on intimate relationships, quality of life, and self-esteem. History and physical examination are sufficient to form a diagnosis of ED in most cases, because there's no preferred, first-line diagnostic assay . Initial diagnostic workup should usually be limited to a fasting serum glucose level and lipid panel, thyrotropin test, and morning total testosterone level. First-line therapy for ED consists of lifestyle changes, modifying drug therapy which will cause ED, and pharmacotherapy with phosphodiesterase type 5 inhibitors. Obesity, sedentary lifestyle, and smoking greatly increase the danger of ED. Phosphodiesterase type 5 inhibitors are the foremost effective oral drugs for treatment of ED, including ED related to DM , medulla spinalis injury, and antidepressants. Intraurethral and intracavernosal alprostadil, air pump devices, and surgically implanted penile prostheses are alternative therapeutic options when phosphodiesterase type 5 inhibitors fail. Testosterone supplementation in men with hypogonadism improves ED and libido, but requires interval monitoring of hemoglobin, serum transaminase, and prostate-specific antigen levels due to an increased risk of prostate adenocarcinoma. Cognitive behavior modification and therapy aimed toward improving relationships may help to enhance ED. Screening for cardiovascular risk factors should be considered in men with ED, because symptoms of ED present on the average three years before symptoms of arteria coronaria disease. Men with ED are at increased risk of coronary, cerebrovascular, and peripheral vascular diseases.