The PDE5 inhibitors have recently been found to have cognitive-enhancing effects in animal models. To investigate the efficacy of repeated dosing with a PDE5 inhibitor on cognitive function and somatization in patients with erectile dysfunction, 27 patients with erectile dysfunction received udenafil (100 mg) at 3-day intervals for 2 months. The international index of erectile function-5 (IIEF-5), a cognitive battery (the Korean version of mini-mental state examination (K-MMSE), the frontal assessment battery (K-FAB), the Seoul verbal learning test) and a physical health questionnaire-15 (PHQ-15) were performed at baseline and at 2 months, following the administration of udenafil. The patients were divided on the basis of their IIEF-5 score into responders (change47) and non-responders. The mean IIEF-5 score was significantly increased after treatment (7.92±3.83 to 16.33±4.75, Po0.001). The scores of K-MMSE (27.03±1.58 to 28.07±1.57, P ¼ 0.001), K-FAB (13.65 ± 1.96 to 15.41 ± 1.85, Po0.001) and PHQ-15 (18.92 ± 4.96 to 17.63 ± 4.75, P ¼ 0.003) were significantly improved after treatment. In addition, the responders (n ¼ 16) had more improved cognitive function (r ¼ 0.603, P ¼ 0.001) and somatization (r ¼ À0.402, P ¼ 0.038) than non-responders (n ¼ 11). Repeated dosing with a PDE5 inhibitor seems to improve cognitive function and somatization, as well as erectile function in patients with erectile dysfunction.