PURPOSE: There are several reports about relationships between cardiovascular risk factors and lower urinary tract symptoms (LUTS). We investigated the effects of risk factors for vascular disease on LUTS and erectile function (ED). MATERIALS AND METHODS: We prospectively analyzed 273 patients who had LUTS or ED. A self administered questionnaire of International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) were given to patients. Cardiovascular risk factors including hypertension, smoking status, diabetes and dyslipidemia were determined in each patients. RESULTS: Mean age was 60.5+/-9.4 years. Mean IPSS, IIEF and IIEF-EF score were 15.9+/-5.9, 30.1+/-15.4 and 17.35+/-9.0, respectively. There are statistically significant differences in the IPSS (p=0.047), IIEF (p=0.024) and IIEF-EF domain score (p=0.044) between men with no risk factors and men with one or more risk factors. IPSS, IIEF and IIEF-EF score were 11.5+/-6.4, 39.8+/-11.9 and 19.6+/-8.7 in men with no risk factor (n=94), 16.6+/-5.6, 28.4+/-15.0 and 15.1+/-9.3 in men with at least one risk factor (n=179). In men with one to four risk factors, the mean IPSS was 14.5+/-5.1 (n=63), 16.3+/-4.4 (n=45), 21.2+/-5.5 (n=43) and 26.5+/-3.5 (n=28)(p=0.001); the mean IIEF score was 31.4+/-14.2, 27.8+/-16.8, 22.5+/-14.1 and 19.0+/-9.9 (p=0.037); the mean IIEF-EF score was 17.1+/-8.9, 14.7+/-9.0, 10.9+/-9.7 and 8.8+/-4.5 (p=0.023), respectively. CONCLUSIONS: Men with risk factors for vascular disease are more likely to have a higher IPSS and a lower IIEF and IIEF-EF score than men without risk factors. These results suggests that vascular disease of men is significantly related with the progression of LUTS and ED.