Erectile dysfunction is a condition that can affect any man at any age, and it is important to identify the causes as well as the condition if it is already present. Erectile dysfunction can be a consequence of another important disease. There are factors of vascular risk such as high blood pressure; smoking, diabetes and the increment of levels of cholesterol in blood, each of them are responsible for serious lesions on the arteries of the organism. Arteries of the penis are very similar to coronary arteries that supply the heart with blood. It has been proven that many patients with vascular risk can develop initially an erectile dysfunction. If these factors are not corrected the vascular disease progress and a myocardial infarct could happen as well as vascular diseases on brain, on the hearth and on many arteries of the organism. At this point it is important to be aware of the fact that erectile dysfunction can be a “sign of alarm” which let the patient know that his arteries are closing. When a patient presents an erectile dysfunction should have a doctor’s appointment in order to prevent hearth diseases. An urologist expert on sexual medicine is qualified to diagnose and treat an erectile dysfunction. Diagnosis and treatment for erectile dysfunction must be individualized for each patient and his partner. A good clinical history made by a professional expert on this field, is the main part of the diagnosis. This basic evaluation (clinical history, exploration and analysis) is useful for a complete study to inform the patient the cause of his problem and thus pick up the right treatment. With the help of ultrasound equipment a detailed vascular study of the penis (eco-Doppler) can be done. With this technique the arterial factor (blood that gets in) can be evaluated and the veno-occlusive factor (the quantity of blood that goes out). This kind of study is essential to identify organic and psychogenic causes for erectile dysfunction. In these days there are many different therapeutic options, treatment should be personalized and solutions are better when the cause is known and there is a possibility to work over it. On patients affected by erectile dysfunction due to problems of psychological type it is fundamental a psychological counseling to talk about the condition with him and his partner in order to help them to overcome the problem. It is especially important to reassure them and decrease the tension levels between the couple. If there is a depression or any kind of psychological problem then a psychiatric treatment will be required. If the patient is affected by erectile dysfunction due to hormonal problems, there can be identified a shortfall on levels of testosterone, therefore they can appeal to a quick recovery by means of a treatment of testosterone replacement. Most of the treatments available for erectile dysfunction are intended to achieve an erection during sexual intercourse, but they are unable to cure the condition completely except for Vimax, a revolutionary product.