Introduction: Erectile dysfunction (ED) is a common condition in patients with renal disease, but little is known about the prevalence of ED in some specific groups of patients such as Peruvian hemodialysis (HD) patients. Materials and Methods: A cross-sectional study was conducted to determine the frequency of ED in HD patients (n = 390) in Lima, Peru. The prevalence and severity of ED were assessed using the International Index of Erectile Function with the validated Peruvian version. The dependence of ED on independent variables was evaluated by logistic regression. P ≤ 0.05 was regarded as statistically significant. Results: This study collected 390 patients with end-stage renal disease on HD, 300 (76.6%) with ED. The average age was 66.15 years, 87.3% had ≥50 years, diabetes mellitus (30.7%), hypertension (26%), glomerulonephritis (16%), and no filiated 17.3% and 66% had been on HD for more than 5 years. Severe ED was 29.2%, moderate ED by 21.5%, mild/moderate 17.4%, and mild ED 8.7%. Patients ≥50 years were more likely to experience ED. Adequacy of dialysis, as measured by the Kt/V index, hemoglobin, and albumin were not associated with ED in our data. The antihypertensive drugs included angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (78%), calcium channel blockers (59.3%), alpha-blockers (22.8%), and beta-blockers (5.5%) none were significantly associated with ED. In the multivariate analysis, the age was a strong predictor of ED for 50-59 years (OR = 2.04; 95% CI, 1.36-3.23) and for 60-69 years (OR = 3.48; 95% CI, 1.94-13.5), and diabetes was the only medical condition that remained significantly associated with ED (OR = 1.97; 95% CI, 1.18-4.6). Conclusions: ED frequency was high among our study patients. In Peruvian patients on HD, age and diabetes mellitus were significant risk factors for ED. Our results can give the basic data for future research in this field.