Background: Sexual dysfunction is the commonest reproductive health problem seen among men with diabetes which has different health and social consequences. Previous studies conducted in this area were concentrated to specific domain of sexual dysfunction and factors were not well addressed.Objective: To determine the prevalence of sexual dysfunction and identify associated factors among men with diabetes at the three hospitals of Amhara region, Ethiopia.Methods: Institutional-based cross-sectional study was conducted among 462 men diabetic patients attending at the three hospitals of northwest Amhara region. Systemic random sampling were used and interviewer administered change in sexual functioning questionnaire were collected from February 20, 2020- April 15, 2020. The collected data were entered to Epi-data and analyzed by SPSS. Binary logistic regression was employed and multi-variable logistic regressions model used to control confounders. Variables that had independent correlation with the outcome were identified (with p-value≤ 0.05 and 95%CI) the direction and the strength of the association were measured by Adjusted Odds Ratio (AOR).Results: The prevalence of sexual dysfunction found to be 69.5% (95%CI= (65.1-73.9)). The magnitude of sexual dysfunction has been disproportionately observed among old age individuals (AOR=8.7, 95%CI: (3.3-23.1)), longer duration of diagnosis with diabetes(AOR=10.8, 95%CI: (5.3-21.9)), poor metabolic control (AOR=3.57, 95%CI: (1.81-7.05)), existence of comorbidities (AOR=5.07, 95%CI: (2.16–11.9)) and having diabetic related complications (AOR=3.01, 95%CI=1.31-6.92). Nevertheless, physically active (AOR=0.41, 95%CI: (0.12-0.7)) and couples satisfied with their relationship (AOR=0.15, 95%CI: (0.03-0.7)) were less likely to experience the problem.Conclusion: Well over two-thirds of men with diabetes have experienced sexual dysfunction, implying a public health pressing concern. Older individuals, physical in activity, longer duration of diagnosis with diabetes, having diabetic complication, experiencing co-morbid illnesses, couples un satisfaction, and poor metabolic control increased risk of developing SD. Therefore, promoting physical exercise, preventing co-morbid illnesses, couples counseling to build good relationship are recommended for combating the problem.