Penile glans ischemia or necrosis developing after internal pudendal arterial embolization is very rare; no relevantreport has yet appeared. A 53-year-old male who visited our emergency room because of massive urethral bleedingwas diagnosed with an internal pudendal artery-urethral fistula; he underwent selective embolization of the internalpudendal artery. However, unexpected penile glans ischemic necrosis developed after embolization. We successfullytreated the patients with intravenous infusion of alprostadil, oral pentoxifylline and tadalafil.