Background. Sexual dysfunction (SD) is a common problem in end-stage renal disease (ESRD). In contrast to basic and clinical research in the field of male SD, the sexual problems of women have received relatively little attention and are often under-treated. We evaluated sexual function in female ESRD patients using the validated Female Sexual Function Index (FSFI) and relation with QOL, depression, and some laboratory parameters. Methods. 117 ESRD patients (85 peritoneal dialysis [PD], 32 hemodialysis [HD], mean age 48.5 ± 13.9 years) were enrolled. All patients had been dialyzed (PD or HD) for more than three months. In addition, an age-matched married control group of 48 subjects (mean age 47.1 ± 12.7 years) were enrolled in the study. All patients were asked to complete three questionnaires of the FSFI, Beck Depression Index (BDI) and SF-36. Results. Female sexual dysfunction was found in 80 of the 85 peritoneal dialysis patients (94.1) and all of the HD patients (100), but in only 22 subjects of the control group (45.8). A significant negative correlation was found between total FSFI score and age (r -0.288, p 0.002), BDI score (r -0.471, p < 0.001), mental-physical component score of QOL (r -0.463, p < 0.001 and r -0.491, p < 0.001, respectively) in PD and HD patients. The rates of depression were 75.3, 43.8, and 4.2 in the PD and HD patients and control subjects, respectively. Conclusion. Female sexual dysfunction is common problem ESRD. This problem especially related with depression and QOL. Thus, sexual function should be evaluated in female subjects to determine its impact on quality of life. © 2009 Informa UK Ltd.