Identifying novel risk factors for erectile dysfunction (ED) is crucial for developing targeted intervention. This study aimed to investigate the potential impacts of serum trace elements (TEs) concentration on the risk of diabetic ED. A retrospective case-control study was conducted involving 51 patients with diabetic ED and 51 control subjects. Serum levels of copper (Cu), zinc (Zn), magnesium (Mg), iron (Fe), and calcium (Ca) were measured using inductively coupled plasma-mass spectrometry (ICP-MS). While most selected TEs showed no significant differences, Cu levels were notably higher in patients with diabetic ED. In addition, the Cu/Zn ratio (CZr) was significantly elevated in the diabetic ED group compared to controls (1.3 vs. 1.2 mg/L,