The aim of the present study was to evaluate erectile dysfunction among Egyptian patients with spinal cord injury(SCI) and to study the efficacy, safety and patient satisfaction of different modalities of treatment in such patients including oral sildenafil, intracavernosal injection and vacuum devices. The present study was carried out on 60 men with SCI. The patients were subjected to full history taking, examination, questionnaire evaluation and laboratory measurement. According to the protocol of treatment, the patients were classified into three groups. Finally we concluded that ICI, vacuum device therapy should not be the first line of therapy for SCI patients and sildenafil is an effective drug well tolerated by the patient with minimal side effects and can used in all cases of SCI .