Perineal venous leakage is a cause of impotence that is demonstrated easily by dynamic cavernosography. Perineal ligation of the crura penis was done in 13 patients with this type of impotence. Nine patients achieved satisfactory intercourse and 3 had sufficient erection after intracavernous self-injections of papaverine. Implantation of a penile prosthesis was required in only 1 patient. Ligation of the crura penis is a simple operation that seems to be efficient in the treatment of impotence owing to perineal venous leakage.