Abnormal penile erection is a rare clinical urological emergency, which is a penile hemodynamic disorder and relatively difficult to handle. Timely identification of the cause and correct treatment plan are necessary to avoid complications such as cavernous fibrosis and erectile dysfunction. 1. Clinical data The patient, a 35-year-old male, was admitted to the county hospital six days ago for joint pain in the extremities and was treated with Chinese herbal medicine, and sustained erection of the penis appeared the next day. Later, he went to a provincial hospital for treatment, where he was treated with methotrexate penile injection and penile puncture rinse, but failed to improve. When he came to our hospital, he had had a continuous erection for 144 hours. Examination: the penis was erect, obviously thickened and enlarged, the foreskin was congested and edematous, bruised and painful to touch, there was a 0.5×0.5cm skin ulcer at the root of the left side of the penis, a catheter was left in place, a small amount of bloody fluid was leaking from the urethra, and the bilateral testicles were normal. Under lumbar anesthesia, a 12-gauge needle was used to puncture the left side of the sponge body up and down and the right side of the root, and the accumulated blood could not be drawn out with a syringe, and dark red blood was drawn out after a small amount of saline was aspirated and injected. Postoperative antibacterial sedative dots were given to prevent infection, and the patient was discharged four days after the operation. He was discharged four days after the operation. After one and a half years of follow-up, he occasionally had semi-erect penis and could not complete sexual intercourse. Taking Viagra was ineffective. 2. Discussion Abnormal penile erection is a pathological erectile state that can occur at any age, including those with erectile dysfunction, unrelated to sexual activity, for more than 6 hours, with hypoxia and acidosis of the cavernous tissue. Abnormal erections in young people are most often seen in hematologic diseases such as sickle cell anemia, vasoactive drug injections, leukemia, and tumor metastases compressing obstructing venous return; in older patients, vasoactive drug injections and idiopathic are more common. Overdose of Viagra can also lead to abnormal erection. Abnormal penile erection is divided into two types: ① low-flow type, which is venous reflux disorder, characterized by high blood viscosity, pain, low skin temperature, high intracavernosal pressure, tonic penile erection, and ultrasound shows that both cavernous artery and venous blood flow velocity are slowed down. The patient in this case is consistent with the above-mentioned manifestations. ②High flow type, often caused by trauma to the cavernous artery rupture, pain is not obvious, skin temperature is hot, there is no reflux obstruction, intracavernosal pressure is not high, the penis is full or semi-erect, ultrasound examination shows that both cavernous arterial and venous blood flow is accelerated, because this type of abnormal erection is not locally hypoxic, generally will not lead to ED. The fundamental purpose of abnormal penile erection treatment is to restore blood circulation in the cavernous body of the penis, abnormal erection early ( Early abnormal erection (within 12 hours) can be treated with sublingual Kepone followed by local injection of Alamine, while those with more than 12 hours should be treated with local injection of Alamine after penile cavernosal puncture and decompression. Abnormal low-flow erections, regardless of duration, can be relieved by cavernous decompression and cavernous injection. However, those with recurrent tonic erections even after decompression therapy and without bleeding tendency can be treated with local flushing with heparin saline supplemented with oral aspirin. High-flow type abnormal erection does not cause cavernous tissue hypoxia and fibrosis, and there is no obvious pain manifestation, which can be observed. The abnormal penile erection contingency goes to the treatment. Perform a shunt as soon as possible when conservative treatment is ineffective. The erection is too long cavernous tissue is replaced by collagen fibers. Even if the penis returns to normal after surgery, permanent erectile dysfunction cannot be prevented from occurring. A similar situation occurred in our patient, which should be given clinical attention.