Introduction Endothelial dysfunction has been demonstrated to play an important role in pathogenesis of erectile dysfunction (ED) and vitamin D deficiency is deemed to promote endothelial dysfunctions.

Aim To evaluate the status of serum vitamin D in a group of patients with ED.

Methods Diagnosis and severity of ED was based on the IIEF‐5 and its aetiology was classified as arteriogenic (A‐ED), borderline (BL‐ED), and non‐arteriogenic (NA‐ED) with penile‐echo‐color‐Doppler in basal condition and after intracaversous injection of prostaglandin E1. Serum vitamin D and intact PTH concentrations were measured.

Main Outcome Measures Vitamin D levels of men with A‐ED were compared with those of male with BL‐ED and NA‐ED.

Results Fifty patients were classified as A‐ED, 28 as ED‐BL and 65 as NA‐ED, for a total of 143 cases. Mean vitamin D level was 21.3 ng/mL; vitamin D deficiency (<20 ng/mL) was present in 45.9% and only 20.2% had optimal vitamin D levels. Patients with severe/complete‐ED had vitamin D level significantly lower (P = 0.02) than those with mild‐ED. Vitamin level was negatively correlated with PTH and the correlation was more marked in subjects with vitamin D deficiency. Vitamin D deficiency in A‐ED was significantly lower (P = 0.01) than in NA‐ED patients. Penile‐echo‐color‐Doppler revealed that A‐ED (PSV ≤ 25 cm/second) was more frequent in those with vitamin D deficiency as compared with those with vitamin >20 ng/dL (45% vs. 24%; P < 0.05) and in the same population median PSV values were lower (26 vs. 38; P < 0.001) in vitamin D subjects.