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Sexual dysfunction is a common, underappreciated complication of dia-betes. Male sexual dysfunction among diabetic patients can include disorders of libido, ejaculatory problems, and erectile dysfunction (ED). All three forms of male dysfunction can cause significant bother for diabetic patients and can affect their quality of life. Despite this, health care providers often do not specifically ask their male diabetic patients about sexual func-tion. This results in considerable underdiagnosis because patients are often reluctant or embarrassed to ini-tiate discussion of these issues them-selves. By not recognizing sexual dys-function as a common organic sequel-lae of diabetes that should be addressed and treated, providers are missing an important opportunity to improve their patients ’ daily existence and quality of life. While all three forms of male sexu-al dysfunction can be found among diabetic men, this review will focus on the most common form, ED, because the literature is most mature in this area. Defined as the inability to achieve or maintain an erection suffi-cient for satisfactory sexual perfor-mance, ED is highly prevalent in dia-betic men1 and is almost always organic in its etiology. Given that many patients feel that their ED is “in their heads ” and that “their provider will dismiss any sexual problems they might bring up,”2 it may be a relief for patients to learn that their ED is physical, related to their diabetes, and treatable. To this end, the goal of this article is to review the epidemiology, pathophysiology, quality of life effect, and treatment of ED in men with type 2 diabetes