Nineteen impotent patients were included in the study. Radioisotope penile plethysmography using technetium-99m-labelled RBC was performed on each patient before and after intracavernosal injection of prostaglandin E1 (PGE1) for quantitating the penile hemodynamic change. The peak penile blood flow (PPF) and penile blood volume change (dPV) were evaluated. The results revealed that (a) the PPF values (mean 2.24 ± 1.38 ml/min) of all patients were lower than that of the patients with no arterial changes previously reported, and (b) there was good correlation between PPF and dPV (r= 0.75). We conclude that quantitative radioisotope penile plethysmography coupled with intracavernosal injection of PGE1 is a valuable method for the objective evaluation of the penile erectile response of impotent patients, and that the PPF values of the impotent patients with arterial insufficiency might be a reliable parameter of penile volume change.