The effectiveness of a vacuum erection device was evaluated in a 3-year prospective trial involving 110 men with erectile disorders. The patients ranged from 36 to 75 years of age (average: 61). Fifty-seven had chosen the vacuum device as a first treatment attempt; 27 were on intracavernous self-injections with a vasoactive agent but wanted another treatment; and several treatment modalities had failed in the remaining 26 patients. At the 3-month follow-up, the patients were mailed a questionnaire to evaluate the quality of sexual intercourse with the vacuum constriction device. Partner satisfaction was evaluated in parallel. Improvement in sexual parameters as well as difficulties and side effects induced by the device were investigated. Our results confirm the efficacy of the vacuum constriction device in the treatment of erectile dysfunction in selected patients.