Erectile disorders in men with diabetes mellitus (DM) in combination with autonomic neuropathy are diagnosed and rehabilitation methods of patients with erectile dysfunction (ED) are detected. Thirty patients with DM were examined (15 patients with diabetes mellitus type 1 and 15 patients with diabetes mellitus type 2 respectively). Patients with DM had ED mainly of severe form (IIEF-5 from 6 to 16 points). According to the examination results, the patients were assigned conservative therapy, including phosphodiesterase inhibitors of type V, anticholinesterase drugs, thioctic acid drugs. Conservative therapy was combined with shock wave therapy in the area of the penis. The comparison group consisted of 15 healthy men (volunteers) without ED signs (IIEF-5 21–22 points). The immune-enzyme analysis was used for detection of sex hormone status. Ultrasound, dopplergraphic and X-ray methods were used for conduction of angiography of pool vessels of internal pudendal artery (IPA). Electroneuromyography of penis nerves was made. According to the obtained results, patients with DM were diagnosed with cavernous fibrosis, angiosclerosis of IPA and penis vessels in 100% of cases. Axonopathy of motor and sensory penis nerves was detected in 100 % of cases; stenosis and occlusion changes in IPA were detected in 42.9 % of cases causing disorder and insufficiency in arterial perfusion in the IPA pool. Denervation changes in sensory and motor penis nerves and hemodynamicly significant perfusion disorders in the IPA pool were the principal pathogenetic ED factors in patients with DM. A decrease of the IPA reaction to the pharmological stimulation was noted in patients with DM, which was caused by angiosclerosis and arterial wall elasticity loss. The inefficiency of conservative therapy in patients with DM and severe ED was revealed.