AbstractTwenty diabetic patients (16 NIDDM, 4 IDDM) were managed for erectile impotence using a non‐surgical device‐the vacuum erection device (VED). Their ages ranged from 27 to 71 years with a mean of 50.4 and diabetes duration ranged from 6 to 21 years with a mean of 11.5 years. Duration of impotence ranged from one to 10 years with a mean of 3.3 years and the aetiology was neurogenic and/or psychogenic. One to 14 months after prescribing the device, (mean 3.7 months), four patients rated the system poorly while 16 expressed satisfaction with it. Faulty technique in use of the device was successfully corrected in two of the four and, overall, 18 patients (90%) expressed satisfaction with the VED, scoring it an average 7.7 out of 10 in its ability to correct impotence. Four spouses (20%) had sexual dissatisfaction, six patients (30%) had transient penile discomfort and there was impaired ejaculation in four patients (20%). The VED was effective and safe in managing erectile impotence of neurogenic or psychogenic orgin in Saudi diabetic patients. It was relatively easy to use and culturally acceptable. It could be particularly useful for treating erectile failure among diabetic patients in developing countries.