Abstract: Objectives To evaluate the efficacy of tadalafil in the treatment of ED after holmium laser enucleation of the prostate(HoLEP).Methods A total of 34 patients with ED after HoLEP received 3 months of tadalafil treatment and were followed up for 6 months.The IIEF-5 scores of the patients and Penile erectile hardness were compared before and after the treatment.Results 34 cases of patients with ED markedly improved in 19 cases,effective in 10 cases,invalid in 5 cases,the total effective rate reach 85.3% (29/34).34 patients before treatment,after it and withdrawal after 6 months,the general IIEF -5 rating respectively for 9.9 ± 4.2、19.7 ± 3.8 and 17.3 ± 3.9.The IIEF-5 scores were statistically significant differences among pre-treatment、post-treatment and 6 months after drug withdrawal ( P < 0.05 ).Conclusions Tadalafil can be used as a first-iine drug for the treatment of ED after HoLEP.