Aims of this study were to estimate the prevalence of Erectile Dysfunction among elderly patients attending a primary care clinic at a university hospital, Riyadh, Saudi Arabia , and its association with cardiovascular risk factors like diabetes, hypertension, smoking and dyslipidemia. A cross sectional study was carried out during the period from January 2010 till May 2011 at a primary care clinic in King Khalid University hospital, Riyadh, Saudi Arabia. All Patients 60 years and above visiting the primary care clinic were interviewed by a consultant Family physician. Verbal consent was taken from the patients. Patients were asked about presence of erectile dysfunction as a health problem. Their medical records and their lab results were reviewed in the same consultations to determine their cardiovascular risk factors like diabetes, hypertension, smoking, and dyslipidemia. Data has been entered and analyzed using Statistical Package of Social Science SPSS version 15.5. P value has been considered to be statistically significant if it is less than 0.05%. The study showed that the estimated prevalence of Erectile Dysfunction among 358 elderly patients was 60.6%. Cross tabulation showed that there was a statistically significant association between Erectile Dysfunction and Diabetes, Hypertension, Dyslipidemia, Smoking and increased age of elderly patients. In conclusion: Erectile dysfunction is common health problem among elderly patients attending a primary care clinic, Riyadh, Saudi Arabia. And there is strong association with cardiovascular risk factors. Family physicians should play a cornerstone role in the prevention and management of erectile dysfunction and its cardiovascular risk factors like diabetes, hypertension, dyslipidemia and smoking in the community. It is recommended to do further community based research in the field of erectile dysfunction among elderly patients to fully understand the prevalence of erectile dysfunction and its association with cardiovascular risk factors , and its consequences among elderly men in the community.