Male sexual dysfunction after aortoiliac operations can be a distressing complication. Since previous studies dealing with this problem have not excluded other causes of sexual dysfunction, the true incidence of this complication has been difficult to ascertain. We assessed preoperative and postoperative sexual function in a group of patients with no identifiable organic or functional etiology of sexual dysfunction other than aortoiliac operations or arterial occlusive disease. Seventy-six male patients had no evidence of sexual dysfunction of ambiguous etiology before or after operation. Preoperatively, 33% of patients with abdominal aortic aneurysm and 22% of those with aortoiliac occlusive disease were functionally impotent. Conventional dissection techniques rendered an additional 30% of each group functionally impotent. Postoperative impotence was twice as common in those with minor dysfunction preoperatively.