Background: Erectile dysfunction (ED) is a common condition, often driven by vasculogenic mechanisms like arteriogenic and veno-occlusive dysfunction. Conventional therapies improve erectile performance but do not correct underlying endothelial injury, reduced arterial inflow, smooth muscle loss, or tunical fibrosis. Platelet-rich plasma (PRP), an autologous concentrate rich in regenerative growth factors, has emerged as a potential therapy capable of enhancing angiogenesis, endothelial repair, and cavernosal tissue regeneration. This narrative review aimed to assess the role of intracavernosal PRP therapy in ED, with specific comparison between arteriogenic and veno-occlusive ED. Methods: This narrative review was conducted through PubMed, Scopus, Web of Science, and Google Scholar up to 2025. Search terms included platelet-rich plasma, PRP, ED, arteriogenic, veno-occlusive, and intracavernosal injection. Eligible studies included clinical trials, comparative studies, case series, reviews, and guidelines reporting PRP outcomes in adult males. Conclusion: RP is a promising regenerative therapy for vasculogenic ED, with potential benefits in both arteriogenic and veno-occlusive dysfunction. Although early findings are encouraging, evidence remains limited and heterogeneous, highlighting the need for well-designed comparative studies to optimize patient selection and treatment protocols.