Arterial hypertension is considered a risk factor for erectile dysfunction. The aim of the study was to evaluate the prevalence of erectile dysfunction in hypertensive compared with normotensive individuals of similar demographic characteristics in Greece. Furthermore, the effect of age, hypertension severity, hypertension duration, and antihypertension medication on erectile function of these subjects was investigated. The study population consisted of 634 consecutive young and middle-aged men (31-65 years) that visited our outpatient clinic. From them, 358 patients had arterial hypertension and 276 were normotensive. Erectile dysfunction was evaluated with the International Index for Erectile Function questionnaire. Erectile dysfunction was found in 35.2% of patients with essential hypertension compared with 14.1% of normotensive subjects (chi(2) = 35.92, P < .001). Patients with essential hypertension had more severe erectile dysfunction than their normotensive counterparts (chi(2) = 17.1, P < .001). Hypertension duration, hypertension severity, antihypertension medication, and age were positively correlated with erectile dysfunction. The prevalence of erectile dysfunction is higher in patients with essential hypertension compared with normotensive subjects of similar demographic characteristics. Erectile dysfunction is related to age in both groups, whereas duration and severity of hypertension as well as antihypertension drugs affect erectile function of hypertensive patients. Erectile dysfunction affects patient quality of life, underlining the need for vigorous research of this condition and appropriate management.