The aim of our study was to investigate the role of platelet parameters including mean platelet volume (MPV) and platelet count (PC) in the pathogenesis of penile arteriogenic erectile dysfunction (ED) and to evaluate the association between the platelet parameters and arteriogenic ED.There were 244 patients with ED (based on the International Index of Erectile Function [IIEF]-5 ≤21) and 60 healthy controls (IIEF-5 ＞21) enrolled.All participants were asked to undergo a laboratory examination,and penile vascular function was evaluated using penile color Doppler ultrasonography (pDUS).Among these ED patients,24 patients with no abnormality on nocturnal penile tumescence (NPT) and 84 with normal vasculature or mixed vascular abnormalities were excluded.The other patients were classified into three groups as follows:control (n =60),arteriogenic ED (n =99),and venous leakage (n =37)groups.MPV and PC were significantly higher in the arteriogenic ED group compared with the venous and control groups (P＜ 0.05).Receiver operating characteristic curve analysis revealed that the area under the curve for MPV to predict arteriogenic ED was 0.707.MPV ≥9.65 fl was recognized as a cut-off value for potential arteriogenic ED (sensitivity:47.5％;specificity:91.7％).A significant inverse correlation was detected between MPV and 10-min peak systolic velocity (PSV) (r =-0.34;P ＜ 0.001) in the arteriogenic ED group.These findings suggest that the MPV might be a powerful indicator to predict and diagnose arteriogenic ED,and MPV may be a marker for ED when using pDUS.