OBJECTIVES:  Erectile dysfunction (ED) affects millions of males world-wide. While it is obvious that ED affects individuals Quality of Life, the quantifiable data on disutility associated with ED is still lacking. Moreover, the health utility – impact has not been studied using multiple health utility instruments previously. Our aim was to quantify the disutility caused by different levels of ED using two preference-based health utility indices simultaneously. METHODS: A total of362 middle-aged or older (52-75 year old) males responded to the five-item International Index of Erectile Function (IIEF-5) in the cross-sectional sample of Savitaipale Study in 2007-2008. The  lower score in IIEF-5 (range 1-25) corresponds to more severe ED.  Health utility was assessed with two separate validated preference-based instruments, 15D and SF-6D. Data were adjusted for age, number of morbidities and marital status. Minimally important differences (0.02-0.03 for 15D and 0.04 for SF-6D) were used to guide the clinical interpration of the results. RESULTS: Both 15D and SF-6D were significantly correlated with IIEF-5 (p<0.001). When examining the ED categorically, the adjusted marginal disutility (0.023 in 15D and  0.038 in SF-6D) was statistically significant (p<0.05) and clinically noticiable even at the mild ED (IIEF-5 score of 22-25). The marginal disutility progressively increased with increasing level of dysfunction, and was highest among the males who had not had sexual activity in past 6 months (0.060 in 15D and 0.093 in SF-6D, p<0.001 on both). On average,  a one point decrease in IIEF-5 corresponded to a  0.003 decrease in 15D (p<0.001) and 0.004 in SF-6D (p<0.001).  CONCLUSIONS: Erectile dysfunction can cause a substantial disutility on males.  While this condition may not be life treathening or is not considered a major public health problem societally, the marginal disutility associated with severe ED is comparable or even greater than disutility associated with many chronic morbidities.