BACKGROUND: Sexual satisfaction is an essential component of overall health related quality of life. However, the epidemiology of sexual satisfaction among Ethiopian women is largely unknown. Hence, the present study was undertaken to investigate the sexual satisfaction and its associated factors among married women.METHODS: Community-based cross-sectional study with mixed approach was conducted from March 1 to April 30, 2019 in Kewot District, Northern Ethiopia on a sample of 397 married women. Quantitative data was collected on a face-to-face interview using a pre-tested questionnaire while qualitative data was collected using in-depth interviews. The new sexual satisfaction scale was used to assess sexual satisfaction of the women. Descriptive statistics and ordinal logistic regression analysis were performed using SPSS version 23.RESULTS: The findings showed that half of the participants (50.4%) expressed moderate sexual satisfaction, and only 39% of the participants reported greatest sexual satisfaction. Poor partner communication (AOR = 0.30, 95% CI; 0.11- 0.79], poor sexual self-esteem (AOR = 0.17, 95% CI; 0.08 - 0.36), absence of social responsibility (AOR = 6.52, 95% CI; 3.32 - 12.80), poor sexual function (AOR = 0.36, 95% CI; 0.21 - 0.61), no previous information about sexuality (AOR = 0.06, 95% CI; 0.00 - 0.62) and perception of sexual talk as taboo (AOR = 7.15, 95% CI; 3.86 - 13.26) were significantly associated with sexual satisfaction.CONCLUSION: Several factors could affect sexual satisfaction of married women. Therefore, development of educational programs, pre-marriage counseling and continuous education should be conducted.