Erectile dysfunction (ED) and vascular disease are thought to be linked at the level of the endothelium. Endothelial dysfunction, resulting in the inability of the smooth muscle cells lining the arterioles to relax, prevents vasodilatation. The aim of this study was to assess the predictive value of Arteriogenic erectile dysfunction (ED) for coronary artery disease in men above the age of 40 years. Seventy five patients complaining of arteriogenic ED and 25 persons with normal erectile function were enrolled in the study, both patients and controls were subjected to the following investigations: lipid profile, fasting blood sugar (FBS), body mass index (BMI), waist circumference, penile duplex study for the patients,, stress ECG test, answer the questions of international index of erectile function- type 5 (IIEF-5) (Arabic version), cardiovascular 10-year risk assessment using Framingham and PROCAM scoring systems. The results showed: Significant increased the mean value of Age, Systolic BP, BMI weight, height and Waist circumference in the cases, significant prevalence of obesity and overweight in the cases, significant increased the mean value of Total cholesterol, TAG, LDL, and decreasing in mean value of HDL in the cases, high incidence of positive stress ECG in the cases (25.3%) than that in control (12%), significant difference between patients with positive stress ECG test and those with negative stress ECG test regarding to their lipid profile ,age, BMI and waist circumference with higher values in positive stress ECG for and lower value for (HDL), according to PROCAM and Framingham scoring systems, 30.7% of cases having ≥30% risk of developing 10-year risk of CHD, significant positive correlations between cardiovascular 10-year risk assessment according to PROCAM and Framingham scoring systems, and BMI, and negative correlations with IEEF-5 among cases. In conclusion: An exercise ECG is suggested before starting treatment of vasculogenic ED at least in patients with cardio-vascular risk factors. IHD events were higher in men with documented arteriogenic ED than those without ED. Metabolic syndrome is associated with increasing incidence of vasculogenic erectile dysfunction.