In Upper Egypt, the Forensic Medicine Authority of the Ministry of Justice transfers patients with marital conflicts or accusation of rape a for proper sexual function evaluation, which helps in making its decisions according to the law. Therefore, our study aims to evaluate the pattern of 40 cases referred for sexual function evaluation, their clinical, laboratory, imaging characteristics and finally the decisions of these cases. The study included 40 patients who referred from the forensic medicine authority for erectile function evaluation. Initial evaluation was done through history taking, general & genital examination. Hormonal profile including total testosterone, free testosterone, follicle stimulating hormone, luteinizing hormone, prolactin, estradiol, and random blood sugar were done. Penile color doppler with intra corporeal injection of PGE1 was done. The final decision for erectile function cases was considered as normal evaluation, venogenic, arteriogenic, and psychogenic erectile dysfunction were 35% (14/40), 25% (10/40), 15% (6/40), and 12.5% (5/40) respectively. There is a great diversity in patients referred for medicolegal evaluation in Upper Egypt; with the erectile function problems are the commonest. A more meticulous well-designed approach is needed for proper evaluation of those patients as serious legal consequences result from this evaluation.This article is protected by copyright. All rights reserved.