The purpose of this study was to explore the meaning of sexual performance expectations for adult men with and without erectile dysfunction (ED) and how masculinity ideology and age likely affect perceptions of sexual performance. A convenience sample of men age 50 and older (N = 132) completed questionnaires addressing their physical and sexual health, traditional masculinity ideology, and attitudes about sexuality and aging. A Sexual Performance Beliefs Scale that addresses older men was developed. H1: Results indicate that middle-aged and older men disavowed the importance of sexual performance as a defining feature of masculinity, yet men with ED less strongly rejected the principle that ED undermines performative masculinity, and men with ED and using oral ED medication were even less likely to disagree with the maxim that ED equals troubled masculinity. H2: The hypothesized relationship between age and sexual performance beliefs was not supported. H3: Men endorsing a traditional masculinity ideology predictably endorsed the principle that sexual performance signifies masculinity. These findings are discussed in terms of adult men’s sexuality and possible clinical implications.