Cardiovascular disease (CVD) and erectile dysfunction (ED) are 2 closely intertwined disease processes. Over the past 2 decades, there have been many studies that have linked both conditions and established ED as a risk factor for CVD. In the United States and worldwide, a large population of adult men has ED and/or CVD. Worldwide, approximately 140 million men have ED, and the number is expected to double in the next 15 years. Because ED and CVD share many of the same risk factors, the relationship between CVD and ED is a very valid concern. Our goal is to examine the association and pathophysiological relationship between ED and CVD. We will also review common risk factors, current treatments, and management of the 2 conditions. Finally, we will discuss the risks of sexual activity in patients who have CVD.