Erectile dysfunction (ED) is reported to coexist with cardiovascular disease. It may be the first clinical manifestation of cardiovascular disease making it a helpful, early marker. Psychogenic causes are also an important component of ED. Around half of all men over the age of 40 years are affected by ED but treatment is often not requested by the patient. ED can be successfully treated pharmacologically. PDE-5 inhibitors are currently the treatment of choice. Physicians should initiate discussion about sexual health and ED in the diagnosed cardiovascular patient.