Background: Lead exposure causes a wide range of vascular diseases through oxidative stress, sympathetic hyperactivity and impairment in nitric oxide bioavailability. In this study, the association between the effects of lead exposure on left ventricular diastolic indices and erectile function were assessed. Methods: A total of 94 lead-exposed workers without known cardiovascular diseases or risk factors and 30 healthy subjects were enrolled. Systolic and diastolic functions were measured using transthoracic echocardiography. All participants were non-smokers. The International Index of Erectile Function Questionnaire (IIEF-5) was used to diagnose and grade erectile dysfunction (ED). Echocardiographic parameters, IIEF-5 score and blood lead level (BLL) were analyzed. Results: The mean age and median BLL were 32.3  6.4 years and 19 g/dL in the workers, respectively. Sixty-five (69.1%) workers and 9 control subjects (30%) had ED. The IIEF-5 score was lower in the workers (17.0  6.1) than in the controls (22.7  2.1). In the workers, E and e’ waves and E/A ratio were lower, and A wave, E/e’ ratio, and left atrial volume index (LAVI) were higher than in the controls. Additionally, BLL was correlated with IIEF-5 score, e’ wave, and E/e’ ratio. IIEF-5 score was correlated with e’ wave, E/e’ ratio and LAVI. BLL was an independent risk factor for a decreased e’ wave and IIEF-5 score and increased E/e’ ratio in the lead-exposed workers. Conclusions: Impairment of diastolic and erectile functions, despite a younger age and in the absence of accompanying risk factors, was correlated with increased BLL.