Abstract Background and Aims Erectile dysfunction is a frequent problem and adversely affects quality of life. In recent years, it has been shown to be an early indicator of cardiovascular disease and endothelial damage. For patients with chronic kidney disease, the incidence of cardiovascular events is increased, while erectile dysfunction is also more frequent. In this study we evaluated in patients with chronic kidney disease the incidence and the association of erectile dysfunction with pulse wave velocity (PWV) and reflection wave parameters. Method The incidence of erectile dysfunction was examined with the use of IIEF (5) Sexual Health Questionnaire in adult male patients aged less than 65 years with chronic kidney disease stage I-V or a history of kidney transplantation that were actively monitored or treated as outpatients. Peripheral blood pressure, central blood pressure, PWV and reflection wave parameters (augmentation pressure and augmentation index) were evaluated using the Mobil-o-graph device in office measurements. Results Overall, 69 men with a mean age of 46.5 ± 11.79 years were included in the study. Chronic kidney disease (CKD) classification according to baseline eGFR calculation was as follows: 12 patients with CKD-I, 27 with CKD-II, 12 with CKD-III, 6 with CKD-IV and 12 with CKD-V on maintenance hemodialysis. Erectile dysfunction of all degrees (mild to severe) was detected in 52% of patients. From the correlation of the various parameters assessed with the degree of erectile function, as calculated by the IIEF questionnaires, it was found that renal function as expressed by eGFR showed a positive correlation (r = 0.24, p = 0.047), while age and PWV showed a negative correlation (r = -0.384, p = 0.002 and r = -0.474, p<0.001 respectively). Moreover, pulse wave velocity was the only parameter which could predict erectile dysfunction (β = -0.995, 95% CI -0.465 to -10.074, p = 0.032). Conclusion The results of the study showed that worsening kidney function is associated with an increase in arterial stiffness and an increase in the incidence of erectile dysfunction. Moreover, erectile dysfunction was more common in patients with increased PWV.