Aim of the work: study was done to compare the benefits and risks for patients doing insertion of penile prostheses for treatment of erectile dysfunction by two different approaches (sub-coronal and penoscrotal) and to try discover the most suitable one. Patients and Methods: a total of 24 patients were included in this study that had all complaining from sever erectile dysfunction. All patients were subjected to pre as well as post-operative fixed assessment. International Index of Erectile Function (IIEF), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). Patients were classified into two groups according to the approach of implantation. Procedure was done for every individual patient. Analysis of the final results was done to compare the different procedures and evaluate them individually and comparatively in an effort to categorize the overall benefit of each procedure. Results: each of the two test groups showed a significant improvement and satisfaction of complaining, as well as a significant difference between the two groups as regard(EDITS) (p-value <0.005). Conclusion: In general, management of erectile dysfunction had a strong impact on the quality of life of the patients especially who   underwent the penile prostheses implantation, most significantly affecting their “selfesteem",  the penoscrotal approach was more suitable for semi-rigid penile prostheses than subcoronal one.