ABSTRACT Introduction Erectile dysfunction (ED) is commonly shown to be associated with subsequent cardiovascular mortality, but not respiratory mortality, despite respiratory disease being highly prevalent among ED patients. Aim We aim to examine associations of ED with all-cause and cause-specific (i.e., cardiovascular and respiratory) mortality in a prospective cohort of 1,436 Chinese men, followed up from 2001 for a median of 11.5 years. Methods ED measurement was based on a single question of four categories at the 4-year follow up. Main Outcome Measures Outcome measures include all-cause and cause-specific mortality (i.e., cardiovascular and respiratory mortality, classified according to the International Classification of Disease-version 10 [ICD-10]). Multivariable regression models estimated associations between ED and all-cause and cause-specific mortality, adjusting for the presence of chronic conditions, and socio-demographics and lifestyle factors. For each category of disease-specific mortality, subjects with the corresponding diseases and death cases from other causes were excluded. Cancer mortality was included for comparison. Results Participants who were completely impotent had significantly increased risk of all-cause (HR = 1.63, 95% CI = 1.20–2.23), cardiovascular (HR = 3.94, 95% CI = 1.77–8.76) and respiratory mortality (HR = 3.16, 95% CI = 1.46–6.81) compared with non-impotent participants, adjusting for chronic conditions, and socio-demographics and lifestyle factors. Conclusion ED is significantly associated with subsequent all-cause mortality, possibly via its association with cardiovascular and respiratory mortality. Primary care practitioners should pay attention to ED patients' cardiovascular and respiratory risk profiles, which may benefit their prognosis.