OBJECTIVE To evaluate the complications and prosthesis survival associated with implantation of the Mentor Alpha-1 inflatable penile prosthesis (IPP) for the treatment of erectile dysfunction (ED). METHODS Between August 1995 and March 2003, 65 patients underwent implantation of a Mentor Alpha-1 IPP at the Urological Departments of Skejby or Aalborg University Hospitals. Patient data were obtained retrospectively from medical files. RESULTS The follow-up period ranged from 1 to 96 months (median 48.5 months). Twenty-one patients (32%) experienced complications that required revision. The majority of complications consisted of mechanical problems, but infection was also a large contributor to the complication rate. Seven patients (11%) had the prosthesis permanently removed due to infection. Kaplan-Meier estimates of the 5-year prosthesis survival rates with and without successful revisions due to complications were 88% and 63%, respectively. CONCLUSIONS The Mentor Alpha-1 IPP is an efficient treatment for ED in situations where less invasive therapy has failed. The risk of infection or mechanical failure must not be ignored. Patients should be informed of this risk before agreeing to implantation surgery.