To explore the mechanism of action, as well as the risks and benefits of two popular and effective treatment modalities for erectile dysfunction (ED). Intracavernosal injection (ICI) therapy involves direct injection of vasoactive agents into cavernosal tissue to facilitate erection. Commonly perscribed agents include PGE1 (alprostadil), papaverine, and phentolamine. Though there are some risks associated with improper injection technique, these agents have a low side effect profile and have proven to be very effective, especially in combination. Patients may also chose the less invasive option of a vacuum erection device (VED), which are often successful in ED of any etiology.