How does women's body image shape their interpersonal relationships? Based on recent theories of risk regulation and empirical evidence that sex is an emotionally risky behavior, we predicted that women's body image would predict increased sexual frequency and thus increased sexual and marital satisfaction for both members of established relationships. The current study of 53 recently married couples provided results consistent with this prediction. Specifically, wives' perceptions of their sexual attractiveness were positively associated with both wives' and husbands' marital satisfaction, controlling for wives' body mass index (BMI) wives' global self-esteem, wives' neuroticism, and reports of whether or not the couple was trying to get pregnant, and both of these associations were mediated by increased sexual frequency and higher sexual satisfaction. Notably, wives' perceptions of their sexual attractiveness accounted for 6% of the variance in husbands' marital satisfaction and 19% of the variance in wives' marital satisfaction that was unique from BMI and the other controls. Accordingly, marital interventions may greatly benefit by addressing women's body esteem.