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Sonic hedgehog (Shh) is an important regulator of penile erectile function in adult males, and abnormal Shh signals may be involved in the mechanisms of ED. Current studies on the relationship of the Shh signaling pathway with ED are mainly concentrated on neurogenic ED caused by bilateral cavernous nerve injury, diabetes-induced endocrinological ED, and senile ED. This review focuses on the changes of the Shh signaling pathway in different types of ED and clarifies the mechanisms of the Shh signaling pathway regulating ED, hoping to giv