Background: Erectile Dysfunction (ED) is defined as inability to achieve and/or maintain an erection sufficient for satisfactory sexual performance. Objective: To assess the use of intracavernosal injection of platelet rich plasma (PRP) with and without oral Phosphodiesterase type 5 inhibitors for treatment of ED. Methods: A prospective randomized study included 38 Patients. They were randomly allocated in two groups, 19 each. The two group was treated by daily Phosphodiesterase type 5 inhibitors (tadalafil 5 mg). Group A had intracavernosal injection of PRP, while group B had saline 0.9% (placebo). All patients answered the Arabic version of IIEF-5 questionnaire in structured interview before and 3 months after initiation of therapy. Results: The mean ILEF-5 score in group A was 9.84 before which increased to 17.6 after injection (p-value> 0.001), Meanwhile, the mean ILEF-5 score in group B before injection was 9.89 and after injection was 12.9 (p-value > 0.001). Furthermore, the mean difference for (ILEF-5) score between both groups after injection was 4.68 (p-value > 0.014). Conclusion: ICI of PRP with PDE5 inhibitors improves erectile function and patient satisfaction more than PDE5 inhibitors alone and might be an optional treatment for patients with erectile dysfunction.