Sexual medicine, exemplified by the management of erectile dysfunction, is a traditional pillar of andrology. Erectile dysfunction has received the greatest attention within the specialty area and its management models the progress of the field more generally. This review provides a perspective of the history and contemporary practice of erectile dysfunction management, highlighting aspects of basic science research, epidemiology, and clinical care. Furthermore, the impact of this field as a major health concern in correlation with basic aspects of wellness and disease is acknowledged. The field continues to evolve as a legitimate discipline in medicine and is worthy of ongoing scientific support and activity.