Objective To assess the utility of real?time shear wave elastography （SWE） in diagnosing vascular erectile dysfunction （ED） and to predict the optimal timing for color Doppler flow imaging （CDFI） examination. Methods Patients diagnosed with ED who received intracavernosal injection （ICI） of vasoactive drugs were recruited and categorized based on CDFI findings into three groups： arterial ED （n = 17）， venous ED （n = 33）， and non?vascular ED （n = 29）. SWE technology was utilized to measure the average Young's modulus （E value） of the corpus cavernosum in these patients， both in the flaccid state prior to ICI and at four time points following ICI?induced erection. Subsequently， the differences in E values among the three groups were analyzed. Results There was no significant difference in the E value of the corpus cavernosum in the flaccid state among the arterial， venous， and non?vascular ED groups before ICI （P > 0.05）. However， the E value in the flaccid state for each group was significantly higher than the mean E values observed at the four time points after ICI?induced erection （P < 0.01）. Additionally， the mean E values at these four time points post?ICI were also statistically significant （P < 0.01）. ROC curve analysis revealed that the AUC for diagnosing arterial， venous， and non?vascular ED using the E value after ICI were 0.814， 0.770， and 0.711， respectively， with corresponding cutoff values of 9.98， 8.16 and 7.06 kPa. The combined use of CDFI and SWE cutoff values following ICI?induced erection significantly shortened the detection time for both arterial and venous ED groups （P < 0.01）. Conclusions SWE can accurately measure the E value of the corpus cavernosum following erection induced by the vasoactive drug ICI， thereby facilitating the differentiation of various types of ED. Additionally， when combined with CDFI， this technique can reduce the time required for examination.