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To determine the cardiovascular effects of sildenafil in men with spinal cord injuries (SCIs) at and above the level of T6, we conducted a double-masked, placebo-controlled laboratory-based study.Participants received sildenafil 50 mg or lactose placebo on alternating days 1 hour prior to a 78-minute experimental protocol. Six-minute baseline periods alternated with two 12-minute audiovisual stimulation periods. Participants include 10 men with traumatic SCIs, mean age of 43.Results revealed significant increases in penile circumference with sildenafil compared to placebo (p = .0035). Although there was a trend for patients to acknowledge higher levels of arousal while on sildenafil, results were not statistically significant. Moreover, although there was a trend toward decreased blood pressure and increased heart rate with the use of sildenafil, differences were not statistically significant.Based upon these findings, sildenafil appears to be a safe, effective drug to use in men with SCIs at and above T6.