BACKGROUND: Erectile dysfunction is becoming a public health problem, affecting 22% of men over 40 years of age, where one of the first lines of treatment for this pathology is the use of drugs, so it is necessary to know the effectiveness of new non-invasive alternative therapies that limit the consumption of these substances in the general population. Therefore, the aim of this study was to evaluate the efficacy of extracorporeal shock waves therapy for the treatment of erectile dysfunction. To achieve this, a systematic review was carried out through the databases PubMed, Scopus, Science Direct, Cinhal, Medline, and Web of Science; using the search terms, Erectile Dysfunction, Physical Therapy Modalities, Physical Therapy Specialty, Rehabilitation and Shock Wave Therapy. RESULTS: The search ended with a total of 15 articles, differentiating between two study groups, those patients suffering from organic erectile dysfunction (n = 12) and those suffering from the same pathology after undergoing radical prostatectomy with nerve sparing (n = 3). The combined analysis showed that the group treated with extracorporeal shock waves therapy had a significant increase in erectile function compared to the controls. The Difference in Means was 2.96 points (95% CI 1.93 to 4.61; p < 0.001; I2 63.45). CONCLUSIONS: Extracorporeal shock waves therapy appears to have a positive effect in the treatment of erectile dysfunction, with these changes being reflected in different variables such as erectile function, erectile efficacy or sexual satisfaction. Its efficacy seems to increase with interventions that include two weekly sessions and with the application at least 6000 pulses in each session. TRIAL REGISTRATION: PROSPERO Registration code: CRD42021230001.

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