Background: The main purpose of the study is to analyze the correlation between erectile function and hormonal pattern with 10-year mortality risk using the Charlson Comorbidity Index (CCI). Methods: A cross-sectional analysis of 180 consecutive men attending a Sexual Medicine and Men's Health outpatient clinic between July 2010 and July 2011 was conducted. Inclusion criteria were age over 18 years old, no history of pelvic surgery or radio- or cryotherapy and no treatment with gonadotropin-releasing hormone analogues or antiandrogenic drugs. Variables including age, height, weight, body mass index, CCI, Erection Hardness Score (EHS) questionnaire, hormonal pattern (testosterone [T] and sex-hormone-binding globulin [SHBG]), and biochemical data were prospectively recorded. Free and bioavailable testosterones were calculated using Vermeulen's formula. Low T levels were defined as T < 346 ng/dL. A multivariate analysis was performed of the relationship between the study population's variables and the 10-year mortality risk. Both erectile dysfunction (ED) and low testosterone levels have been related to entities affecting cardiovascular health, such as diabetes, metabolic syndrome, and heart disease. CCI is a validated tool to predict mortality, using a 17-items tool to predict 10-year mortality risk. Results: One hundred and eighty patients were included. The mean age was 55 +/- 12 years old. The rate of ED was 84%. Low T levels were found in 22.8 % of men. In the univariate analysis, the variables of age (p = 0.001), ED (p = 0.001), EHS (p = 0.001), and C-reactive protein (p = 0.019) were related to higher mortality risks according to CCI. In the multivariate analysis, the variables of age (p = 0.001), C-reactive protein (p = 0.022), and ED (p = 0.04) were related to higher mortality risks. Conclusion: Age, C-reactive protein, and ED are related to higher estimated 10-year mortality risk using CCI.