Erectile dysfunction (ED) has long been a problem that has plagued the medical community. According to incomplete statistics, the incidence of ED in China accounts for more than 10% of adult men. In addition to psychotherapy and Chinese medicine, there is almost no effective treatment for ED. In the past 20 years, ED treatment has made great progress, especially the recent official launch of Viagra in China, once again aroused concern about the treatment of this disease, this article on the three major breakthroughs in the past 20 years ED drug therapy is introduced as follows: 1, intracavernosal vasoactive drug injection The most commonly used drugs are poppy bases, or with phentolamine, prostaglandin E1, or a combination of the three. These drugs can relax arteries and cavernous smooth muscle tissue, causing penile erection due to vasodilation in the cavernous body. Although the side effects (mainly persistent penile erection and cavernous fibrosis) and the route of administration of the drugs make it difficult for patients to accept or use them for a long time, the method is still recommended because of its efficacy and moderate price. The method can be self-injected at home under the guidance of a medical professional. In 1996, the application of prostaglandin E1 intraurethral injection (MUSE) changed the route of administration of vasoactive drugs in the penile corpus cavernosum, making it more convenient and less painful for patients to use. Only the efficacy is slightly inferior to that of cavernous injection, and individual patients may experience local pain. At present, the domestic Prostil urethral suppository (prostaglandin E1) has completed clinical trials, its efficiency 68.1%, people are trying to wait for it to be further improved. 3, 1998 Viagra (Viagra) was introduced “Viagra” is the phonetic after the customary name, the chemical name “sildenafil citrate tablets”. It was a new drug developed by Pfizer in 1992 for the treatment of angina pectoris, and was re-declared as a special drug for the treatment of ED in 1997 because of its effectiveness in treating ED. Viagra is a type 5 phosphodiesterase inhibitor that relaxes cavernous smooth muscle through the nitric oxide-cyclic guanosine monophosphate pathway to achieve erectile effects. To date, a total of 21 clinical studies have been completed worldwide, with about 3,000 cases of ED patients aged 19-87 years (including organic, psychogenic, mixed) participating in clinical trials, resulting in an overall efficiency of 40-80%. Generally 1-5 hours after taking the drug in the sexual excitement onset. Its side effects mainly include headache, flushing, nasal congestion, skin rash, and transient visual disturbance. It is worth noting that this product cannot be taken simultaneously with nitro drugs (including nitroglycerin, isosorbide nitrate, etc.), otherwise it may lead to a sudden drop in blood pressure, which can be life-threatening in serious cases.