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Erectile Dysfunction (ED) affects 10% of men and those affected may present at Genitourinary Medicine clinics. It may indicate significant underlying pathology and is often the first presenting symptom of cardiovascular disease (CVD) and diabetes.All new referrals to the sexual dysfunction clinic in 2006 were identified. Electronic medical records were reviewed to determine clinical outcomes 10 years after initial attendance.138 patients identified; 9 were excluded due to unavailable records. Mean age at referral was 47 years. 68% (n=88) had predominantly organic ED (mean age 52 years) while 32% (n=41) were diagnosed with an underlying psychological cause (mean age 37). Of those with an organic cause, 20% (n=18) had known CVD and 17% (n=15) had diabetes. By 2016, 10% (n=13) of all patients had died. Of those alive, 30% (n=35) remained on treatment for ED. In the intervening years, a further 10 patients were diagnosed with CVD, 9 diabetes, 3 peripheral vascular disease, 3 Parkinson’s disease and 2 with stroke. Of those initially referred with ED, after 10 years, 41% had proven CVD, 27% were diabetic and 10% developed other associated conditions.10-year outcomes for patients presenting with ED are associated with significant levels of morbidity and mortality. The incidence of underlying vascular disease and chronic conditions in this cohort of patients is significant. Recognition of ED is important in GUM settings to enable early detection of significant underlying co-morbidities.