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BACKGROUND Arterial erectile dysfunction (ED) is an early sign of vascular damage. Rare evidence has been published so far as to whether subclinical hypothyroidism (SCH) affects arterial erectile function. Therefore, the objective of this study was to fill this gap. METHODS Patients with arterial ED and SCH were consecutive enrolled and randomly divided into Group A (n = 2 and Group B (n = 2. Group A was treated with levo-thyroxine (LT4) at the dose of 1 µg/kg/day for six months, whereas patients of the group B did not receive any