Objective: This study aimed to compare women's body image, sexual function and satisfaction before and after gynecologic cosmetic surgery. The study also aimed to assess women husband's sexual satisfaction. Materials and methods: This was a pretest-posttest study. A sample of 50 women attending the pelvic floor clinic of Tehran University of Medical Sciences for gynecologic cosmetic surgery was entered into the study. Surgeries included labiaplasty, clitoral hoodectomy, vaginoplasty, vaginal rejuvenation, anterior and posterior colporrhaphy, perineoplasty, and perineorrhaphy. Women were assessed for the Body Image Quality of Life Inventory (BIQLI), the Larson Sexual Satisfaction Questionnaire (LSSQ-F), and Female Sexual Function Inventory (FSFI-6) at two points in time: baseline (one week before surgery) and 3 months after surgery. Similarly, the male partners were assed for sexual satisfaction using the Larson Sexual Satisfaction Questionnaire (LSSQ-M). To analyze the data paired samples t-test was applied. Results: The mean (SD) age of women was 43.36 (8.6) years and the mean (SD) duration of marriage was 22.18 (9.7) years. Ninety-four percent had history of vaginal delivery and 58.7 percent attend surgery due to husband's sexual dissatisfaction. The results showed that women's body image, sexual function and couples' sexual satisfaction improved significantly after gynecologic cosmetic surgery (p ≤ 0.001). Conclusion: The findings suggest that female genital cosmetic surgery improved the body image and sexual function of women and sexual satisfaction in couples that might lead to a more pleasurable and healthier marital relationship.