Erectile dysfunction (ED) is a complex, multifactorial disease caused by multiple factors including difficulty with erection initiation, arterial filling, and occlusion to maintain turgor. It may be a manifestation of poor overall health or specific medical conditions. Treatment of underlying causative conditions may resolve ED. Medical treatment options for ED include oral medications, such as phosphodiesterase type-5 inhibitors, as well as locally acting agents and nonsurgical devices. Locally acting agents include alprostadil, which may be administered by intracavernosal injection, intraurethral suppository, or topical cream, as well as other intracavernosal injection agents. Vacuum erection devices are available. Surgical management options for ED include penile prosthesis placement or vascular surgery. Penile prostheses may be malleable or inflatable. Arterial vascular surgery has shown some efficacy in ideal candidates, but venous surgery is not recommended. Treatment options that are currently being studied and show promise include low-intensity extracorporeal shockwave therapy and regenerative treatments such as stem cells and platelet-rich plasma.