INTRODUCTION: Conventionally, little attention has been given to the association of risk factors and medical comorbidities with male sexual dysfunctions. Although that association has been recently shown in many studies, it is not yet well investigated in the Saudi community. AIM: To investigate the association of risk factors and medical comorbidities with male sexual dysfunctions in the Saudi community. METHODS: A total of 1,464 male patients with a clinical diagnosis of sexual dysfunctions were enrolled in this study. All patients were assessed for sexual functions using different domains of the International Index for Erectile Function. Patients were also interviewed for sociodemographic data, medical history, and risk factors for erectile dysfunction (ED). Routine laboratory investigations, plus total testosterone and prolactin assessments, were offered to all patients. Assessments of penile vasculature using Doppler ultrasonography and rigidometer were performed. RESULTS: A total of 92.6% of the patients had ED, 50.8% had premature ejaculation (PE), and 7.6% had low sexual desire. There was a significant association between increased age and increased severity of ED. In total, 20% had psychogenic cause, whereas 80% had organic cause of ED. Of the patients, 10.2% had mild, 41% had moderate, and 48.8% had severe ED. There were significant associations between endocrinopathy and both low sexual desire and PE (P < 0.05). There were significant associations between increased severity of ED and presence of diabetes, hypertension, dyslipidemia, ischemic heart disease, myocardial infarction, and psychological disorders. There were significant associations between increased severity of ED and increased values of end diastolic velocity, decreased values of peak systolic velocity, resistive index, rigidometer, and decreased response to intracavernosal injection (P < 0.001). CONCLUSION: This study provides an assessment of the association of risk factors and medical comorbidities with male sexual dysfunctions in ambulatory service in this community.