The preoperative frequency and postoperative status of male sexual potency was studied prospectively in 46 patients who underwent abdominal aortic aneurysmectomy, aortoiliac and aortofemoral bypass grafting, or percutaneous transluminal angioplasty of the iliac artery. The patients with aortic aneurysms were older; approximately half of them were potent. The frequency of impotence was highest in patients who underwent aortoiliac bypass, and correlated well with their low penile to brachial pressure index. Patients who had angioplasty had more localized lesions, a higher penile to brachial pressure index and the lowest rate of impotence. Postoperatively, 13% of the patients regained nocturnal erection and 10% became functionally potent (defined as the ability to achieve penetration). The improvements were similar in bypass and angioplasty patients. No patient experienced deterioration in sexual potency and all showed a markedly improved thigh to brachial pressure index postoperatively. Routine aortoiliofemoral artery angiograms were of limited value in predicting the status and outcome of sexual potency in this series of patients.