This chapter discusses cardiodiabetes and sexual dysfunction. Diabetes is the biggest sexual health tsunami of 21st Century. The most common complication of type 2 diabetic men is erectile dysfunction (ED). Diabetes also is a prime risk factor for cardiovascular disease (CVD). Hyperglycemia which is the hallmark of diabetes results in myocardial damage after ischemic events. Erectile dysfunction is defined as the persistent inability to achieve or maintain penile erection for successful sexual intercourse, causing decreased quality of life in men. The pathogenesis of ED in diabetes is multifactorial, as it depends on both psychological and organic factors (which play major roles in ED), mostly diabetic vasculopathy which includes microangiopathy, macroangiopathy and endothelial dysfunction, autonomic neuropathy, insulin resistance, visceral adiposity and hypogonadism. Female sexual dysfunction has been described in diabetic women since the early 1980s. Sexual disorders reported in women with diabetes include the reduction or loss of sexual interest or desire, arousal or lubrication difficulties, dyspareunia, and loss of the ability to reach orgasm.