The ad is the harshest yet from Cardon, who has been spending heavily from his own pockets to attack Flake in the race. This ad has more than $250,000 behind it, according to a Democratic ad tracker.
Flake's campaign shot back, defending Flake's record and attacking Cardon for using doctored photos in the ad.
"Jeff Flake is one of the most known conservative reformers in Congress," Andrew Wilder, the campaign's communications director, wrote in a memo to reporters.
"Cardon gets around inconvenient facts like this by Photoshopping President Obama into a photo of Flake at a Republican Study Committee press conference."