In the medicinal therapy of erectile dysfunction (ED), both oral as well as local application are possible. The introduction of the PDE-5 inhibitor Sildenafil, as the first highly potent oral therapy for ED, caused dramatic changes in the diagnostic and therapeutic strategies in this area. The later PDE-5 inhibitors Tadalafil and Vardenafil show, as far as it is currently possible to judge, a similar profile to Sildenafil. The only previously available oral therapeutic, Yohimbin, plays an insignificant role, and the initial hopes for Apomorphin as an ED therapeutic have settled to a realistic level. Local application therapies have also become less important, with the intra-urethral application of PGE(1) being reduced to a few clinical indicated situations. The intra-cavernosal pharmacotherapy with PGE(1) is considered the gold standard when oral therapies do not work or can not be used.