ABSTRACT Erectile and cardiovascular dysfunctions in cigarette smokers are important signs resulting probably due to pelvic autonomic neuropathy with damage to the parasympathetic nervi erigentes. Evidence related to neuropathic etiology comes from studies that show structural changes in autonomic nerve fibers supplying the corpora cavernosa. The objective of this study was to evaluate the effect of cigarette smoking on penile mid shaft circumference and length, penile pulse amplitude, both systolic and diastolic blood pressures, and heart rate in response to erotic stimulation in young Saudi men living in Western region of Saudi Arabia (Makkah). In this free-living population study data was collected from100 men each (mild, moderate and heavy cigarette smokers) ages between 20 and 35 years with a mean age of 26.42 ± 10.69 years along with 100 age matched healthy non smokers who served as controls. Heavy cigarette smoker group showed a significant decrease (p