The efficacy of two types of an external vacuum device designed to overcome erectile dysfunction was evaluated in 78 unselected patients. In 80% an organic aetiological factor was found. Although 77% of the men were able to achieve an erection adequate for penetration, only 46% continued treatment after 1 month. Among the reasons for discontinuation were ineffectiveness in 18 (23%), side effects in 7 (9%), recovery of spontaneous erection in 6 (8%), the time-consuming nature of the procedure 5 (6%), lack of acceptance of patient and partner 4 (5%), the high costs of the pump 2 (3%). The highest discontinuation rate was encountered in patients without signs of organic aetiology (81%). The device provides a non-invasive, reversible and safe alternative for the treatment of erectile dysfunction. It does not necessitate comprehensive aetiological assessment of erectile dysfunction. There are no differences between the results of vacuum device therapy (this study) and autoinjection therapy (the literature). The selection of patients who may profit by the vacuum device is enhanced if the patient is allowed to practice in his own private environment before purchasing the device.