In the not too distant past, the physician caring for the impotent patient had few therapeutic options. With the recent advances in penile pharmacotherapy, vascular surgery, and prosthetics, several possibilities for treatment are now available. Before a decision is made, however, numerous factors must be taken into consideration: age, manual dexterity, cause of erectile dysfunction, psychological attitude, and social considerations. Clearly, the choice of therapy for impotence must now be made on an individual basis after a careful diagnostic evaluation and in-depth consultation with the patient. Only then can the treatment that offers the highest likelihood of success, both functional and emotional, be chosen.