In this retrospective study, we aimed to evaluate the relationship between erectile dysfunction (ED) and chronic lead intoxication (CLI) as well as the role of depression in this relationship. We compared the findings of 26 male patients with CLI and 24 male patients as the control group between November 2008 and January 2009. The blood lead levels and smoking index of patients were evaluated for both groups. The International Index of Erectile Dysfunction-erectile function domain (EFD) and Beck Depression Inventory (BDI) were obtained and reviewed in both groups. The mean blood lead levels of patients in the CLI and control groups were 42.1 and 3.2gdl(-1) respectively (P<0.01). The mean interval of lead exposure of patients in CLI group was 71.5 (6-360) months. EFD scores of patients in CLI group were significantly lower, and number of patients with ED in CLI group was statistically higher (P<0.05). BDI scores of patients in CLI group were significantly higher (P<0.05). We detected a mildly negative and statistically significant relationship between the EFD scores and blood lead levels (r=-0.453 and P<0.05). Our results showed that the increased frequency of ED is an independent factor in CLI group.