Since the 1970s, penile prostheses, both semi-flexible and inflatable, have been used for surgical treatment of impotence. The semi-flexible implants are highly successful and the rate of complications is low (8%). Indications for penile implants include organic and psychogenic cases, operation in the latter group often being done after unsuccessful psychotherapy. The contraindications are very few. Preoperative, intraoperative and postoperative antibiotic coverage of patient, implants, sizers, dilators and wound is essential and has reduced the incidence of infection from an original 15% (first 20 patients) to 0.5%. Recently, trimming of the implant tails has enabled the surgeon to require fewer prosthesis sizes in the operating room, thus reducing their cost to patients. An additional benefit of the surgical treatment of impotence by penile implantation of a semi-flexible prosthesis is indirect treatment of infertility when infertility is caused by impotence.