Diabetes mellitus (DM) may cause devastating effects on sexual function by virtue of its effects on both neurologic and vascular components. Additionally, the presence of poorly controlled diabetes may increase the morbidity associated with the treatment of erectile dysfunction (ED). In the Endotext chapter “Medical and Surgical Therapy of Erectile Dysfunction”, Bochinski and Lue review the pathophysiology, work-up, and treatments for erectile dysfunction of any cause. In this chapter, we will focus specifically on sexual dysfunction in diabetics, with particular emphasis on practical information for practicing clinicians.