Abstract Objectives To investigate the effects of Low Intensity Extracorporeal shock wave therapy (LI-ESWT) in patients with Peyronie’s disease (PD) and erectile dysfunction (ED) Methods 57 patients with a history of PD and DE were enrolled in a retrospective study. All patients were evaluated for DE and LUTS and in all of them penile ultrasound and photographs were performed. Erectile function (EF), pain during erection, plaque size, penile curvature, and quality of life (QoL) were assessed at baseline and at 3 months of follow up. Six weekly treatment sessions were administered. Each LI-ESWT session consisted of 3000 focused shocks waves with a running time ranging from 18 to 25 minutes. EF was evaluated with the International Index of Erectile Function (IIEF-5). Penile curvature was measured in degrees. Results The mean age was 62.8 years. Of the 57 patients, three of them dropped out for other reasons. After 3 months overall patients improved their QoL score. At 3 months patients had an improvement in penile curvature and a decrease in plaque size. Many of them reported a non-painful erection. Interesting outcomes were reported for IIEF-5 score: 3 patients switched from severe to moderate IIEF5, from 9 to 15.3 (p=0.005); 9 patients switched from moderate to slight, from 19.4 to 21.7 (p=0.007). Unfortunately, 3 patients remained with severe DE (p=0.03). The main limitation of this study was that the QoL score questionnaire was not validated. Conclusions In patients with PD and DE, LI-ESWT is a safe and efficient treatment that improves patients' quality of life and erectile function. Conflicts of Interest The authors declaire no conflict of interest.