Background: This study investigated the correlation between epicardial adipose tissue (EAT), a measure of central obesity, and sexual function in males with vasculogenic erectile dysfunction (ED). Materials and Methods: The study was a cross‑sectional study of selected males with ED aged <75 years who attended the Urology Outpatient Department of Tri‑Service General Hospital. Sixty subjects were included in the study, which employed biochemical data, anthropometric indexes, echocardiography, and questionnaires. Biochemical lipid profiles and associated inflammation markers were recorded. The anthropometric indexes included general and central obesity and bioelectrical impedance analysis. Echocardiography results were assessed by a single experienced cardiologist and included epicardial and pericardial fat thickness measurements. Sexual function was evaluated using the International Index of Erectile Function‑5 (IIEF‑5) score. Results: According to the analysis of variance and multivariate logistic regression, only the erectile hardness score (EHS) was statistically positively correlated with the IIEF‑5 score. All other anthropometric indexes and echocardiography parameters, including EAT thickness, pericardial adipose tissue thickness, and ejection fraction (EF), were not significantly associated with sexual function. Conclusions: Only EHS was statistically associated with sexual function in the male subjects with ED. The anthropometric indexes and EAT thickness, a measure of central obesity, were not significantly correlated with sexual function in the male patients with ED.