Objective: Comparison of data collected in a electronic medical record (EMR) database on men age 21 years and older with and without erectile dysfunction (ED) on concomitant drug prescription, co-morbid conditions, smoking status and BMI. Methods: A retrospective review of the General Electric Centricity MQIC research database containing the ambulatory health records of US patients was conducted. ED patients age 21 and older were identified by diagnosis, PDE5 and/or both; = 18 month of activity and smoking status was required. Two non-ED age-matched (within +/- 2 years) controls were randomly selected for and linked to each case. A matched case-control analysis was conducted using conditional logistic regression, with goodness of fit and residual analyses used to test validity and assumptions. Results: Non-smokers compared to current smokers were less likely to develop ED. There was an increase odds of ED with each unit increase in BMI. Men with BMI 30 - 39.9 had the highest risk of ED (2.14 OR, 1.73 - 2.64 95% CI) compared to those with BMI = 18.5. Antihypertensive, lipid lowering agents and diuretics had the highest relative odds for ED respectively (2.43 OR, 2.34 - 2.5 95% CI; 1.57 OR, 1.52 - 1.62 95% CI; 1.44 OR, 1.37 - 1.5 95% CI). None of the other risk factors or co-morbid conditions (cerebrovascular disease, kidney disease, anti-arrhythmics, and anti-neoplastics) was found to increase the risk of ED. Conclusion: EMR data provides a means for assessing risk factors for and associated conditions consistent with ED in a real-world setting, including the links between this condition and commonly used prescription drugs. The likelihood of developing ED was less for non-smokers and increased with increasing BMI and the use of antihypertensives, lipid lowering agents and diuretics.