PURPOSE: Erectile dysfunction today has a number of effective treatment options. This review was undertaken to examine the contemporary role of penile prosthesis implantation in the treatment of this disorder. MATERIALS AND METHODS: A MEDLINE search was performed on the topic of penile prostheses and implants. Current literature was reviewed with regard to types of penile implants, issues related to prosthesis implantation, results, and patient/partner satisfaction. RESULTS: Mechanical failure rates for early penile prostheses, especially the inflatable type, were unacceptably high. Advances in both prosthesis design and implantation techniques have resulted in increased device survival with 5-year actuarial survival rates free of mechanical failure ranging from 86.2 to 93.6%. Recent reviews of implant recipients show 83 and 85% satisfaction and for partners 70 and 76% satisfaction. CONCLUSIONS: When systemic therapy for erectile dysfunction fails, men have a variety of other options to choose from. Penile prosthesis implantation is an option that is feasible for nearly every man with this disorder. Current device survival rates and patient and partner satisfaction rates are high.