The treatment of male sexual dysfunction in the elderly offers special challenges. Commonly, these men have other conditions requiring medical treatment and the possibility of adverse drug interactions is common. Similarly, the severity of dysfunction is frequently increased by alteration in various organ systems. For instance, ED is commonly associated with significant cardiovascular problems and hormonal alterations. The treatment of these men requires familiarity with the various options available and good clinical judgment to determine when and how modification of therapeutic regimens and combinations of specific drugs may provide the best responses. Frequently one hears the embarrassed older man coming for a consultation and stating that, "At my age, I should not be thinking of this." It is imperative to remember that advancing age does not preclude sexual interest and desire for performance. A well-informed, understanding physician can provide sound advice, institute appropriate therapies, and organize intelligent referrals.