To describe the prevalence of erectile dysfunction (ED) and its association with smoking among the Chinese in Hong Kong, we conducted a cross-sectional study among 819 men (aged 31-60 years) who were randomly selected among the Hong Kong residents and interviewed by trained interviewers. A structured questionnaire was used for data collection. We found that current smokers who smoked 20 cigarettes or more daily had more dissatisfaction, erection difficulty and ED than never smokers. The prevalence of dissatisfaction, difficulty in erection and ED increased significantly (P<0.05) with increasing age. Compared with never-smokers, current smokers of more than 20 cigarettes daily had a greater risk of ED (age-adjusted odds ratio=1.47, 95% confidence interval: 1.00-2.16). Our results support that there are association between ED and smoking among the Chinese and suggest linking ED with smoking in the antismoking campaign and promoting smoking cessation to reduce ED among smokers.