Advertisement user feedback data may be collected and provided to an advertisement decision engine. Advertisements may be presented to users via various electronic media such as digital television, Internet, software, etc., and advertisement feedback user interfaces may be provided to users in connection with such advertisements. An advertisement feedback user interface may be provided via the same electronic medium and device as the corresponding advertisements, or via a different electronic medium and/or device. User feedback data regarding electronic advertisements, as well as additional related data, may be received and provided to one or more advertisement decision engines. An advertisement decision engine may use the advertisement user feedback data to determine a future advertisement to be presented to one or more users at an advertisement insertion opportunity identified in one or more various electronic media.