Background: Psoriasis vulgaris (PV), a systemic immune-mediated disease, comprises chronic inflammation stimulated by psychiatric, genetic, and environmental factors. Acitretin is a systemic retinoid that has been approved for the treatment of PV. There have been some case reports indicating that retinoids may cause sexual dysfunction. Objective: To assess the effect of acitretin therapy on penile erection in psoriatic male cases. Patients and Methods: This study comprised a total number of 31 male patients with psoriasis who were treated with acitretin for at least 2 months. All cases were asked to complete International Index of Erectile Function (IIEF-5) questionnaire before and 2 months from treatment with acitretin. Lesions were scored based on psoriasis area and severity index (PASI) score and Physician Global Assessment (PGA). The dosage of acitretin was 0.5 mg/kg/day, in form of capsules, route of administration was oral for duration of 2 months. Results: When IIEF grades were compared before and after two months of therapy, it was observed that the number of patients with second, third and fourth grades was significantly higher after therapy, while the number of patients with the first grade was significantly lower after therapy. Erectile dysfunction was detected in 11 patients before treatment, all of them were grade 2 and in 27 patients after two months of therapy. Conclusion: Acitretin is associated with a great risk of erectile dysfunction when administrated in treatment of psoriatic male patients and had showed a significant drop in IIEF scores after two months follow up.