According to the Russian Society of Urologists, almost half of men aged 27 to 77 suffer from erectile dysfunction. ED should be considered not only as a medical nosology, but also as a socio-psychological problem with a demographic aspect. There are many methodsfor improving erectile function, including psychological consultations, drug therapy and penile prosthetics. Given the accumulated international experience,the key pointis an accurate diagnosis ofthe cause of erectile dysfunction to determine the correct approach to treatment. Among the many causes of erectile dysfunction, vascular causes are quite common. Given the rapid development of endovascular and low-traumatic approachesto vascular pathology,the technique of improving inflow and outflow obstruction in vasculogenic erectile dysfunction is becoming increasingly obvious and effective. The presented article discussesthe currentstate ofthe issue and possible prospectsfor endovascularsurgery for vascular erectile dysfunction, including significant venous leakage.