OBJECTIVE: To compare use of phosphodiesterase type 5 inhibitors (PDE-5i) between participants with and without self-reported hearing impairment using logistic regression, with and without adjustment for potentially confounding sociodemographic, behavioral, and health-related characteristics. DESIGN: Cross-sectional. SETTING: United States. PATIENTS: A population-based sample of 11 525 men 40 years or older (248,217,013 weighted men) in the United States, selected from the Medical Expenditure Panel Survey (2003-2006). MAIN OUTCOME MEASURE: Self-reported hearing impairment. RESULTS: The overall prevalence of self-reported hearing impairment and PDE-5i use in each group was 17.9% and 2%, respectively. Men who reported hearing impairment were more likely to have also reported the use of any PDE-5i (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.36-3.66). However, this association was limited to sildenafil (Viagra) (OR, 2.05; 95% CI, 1.23-3.43); no significant associations were observed for tadalafil (Cialis) or vardenafil (Levitra) (ORs, 1.40 [95% CI, 0.49-4.04] and 0.88 [95% CI, 0.35-2.22], respectively). CONCLUSIONS: Current warnings regarding the risk of hearing loss related to PDE-5i use seems to be justified. However, the cross-sectional nature of the current study provides only limited insight regarding this relationship, and thus additional research is warranted.