Erectile dysfunction has been associated with atrial fibrillation in cross-sectional studies, but the association of erectile dysfunction with incident atrial fibrillation is less well established.To determine whether erectile dysfunction is independently associated with incident atrial fibrillation after adjusting for conventional risk factors.We studied 1760 male participants (mean age 68 ± 9 years) from the Multi-Ethnic Study of Atherosclerosis (MESA), who completed self-reported erectile dysfunction assessment at MESA Exam 5 (2010-2012). Cumulative incidence of atrial fibrillation was estimated by Kaplan-Meier analysis. Cox proportional hazards regression was used to calculate the unadjusted and adjusted hazard ratios (HR) using three models in which variables were added in a stepwise manner. In Model 3, HR was adjusted for age, race/ethnicity, education, smoking status, alcohol use, systolic blood pressure, body mass index, diabetes, anti-hypertensive medication use, lipid-lowering medication use, total cholesterol, and estimated glomerular filtration rate.During the median follow-up of 3.8 (interquartile range, 3.5 - 4.2) years, 94 cases of incident atrial fibrillation were observed. There was a significant difference between men with and without erectile dysfunction for cumulative incident atrial fibrillation rates at 4 years (9.6 vs 2.9%, respectively, p < 0.01). In the fully adjusted model, erectile dysfunction remained associated with incident atrial fibrillation (Model 3; HR, 1.66; 95% Confidence Interval 1.01 - 2.72, p = 0.044).Among older male participants in this prospective study, we found that self-reported erectile dysfunction was associated with incident atrial fibrillation.