Background: Erectile dysfunction (ED) has been reported to occur as an early manifestation of atherosclerosis. Fetuin-A and YKL-40, (N-termianl amino acid: tyrosine (Y), lysine (K), leucine (L) and its molecular mass 40 kDs) which are glycoproteins secreted by many cells, significantly participate in formation of vascular tissue in healthy and diseased states.Objective: This study aimed at assessment of serum fetuin-A and YKL-40 levels and the carotid intima-media thickness (CIMT) in patients with mild-moderate as well as moderate ED in comparison with control group.Patients and Methods: A total of 90 patients with ED (grade mild-moderate) and 30 healthy participants who attend the outpatient clinic of the Andrology Department, Alexandria Main University Hospital, were included in the study. Enzyme-linked immunosorbent assay was used for measuring both serum fetuin-A and serum YKL-40, and high-resolution B-mode ultrasound was used to measure the CIMT. Results: Statistically significant low fetuin-A and high YKL-40 serum levels as well as a significant increase in CIMT were detected in patients with ED compared with controls. In addition, the ED severity showed a negative and positive correlation to fetuin-A and YKL-40 serum levels, respectively, but there was no correlation to CIMT. Conclusion: fetuin-A and YKL-40 may be used as a predictor for cardiovascular risks in patients with mild to moderate ED.