Introduction <p>With the increase in the older population, sexuality is increasingly accepted as a fundamental element of the general well-being of older adults, which encourages an understanding aimed at increasing their sexual satisfaction and intimacy experiences. The main purpose of this study was to investigate sexual attitudes, gender perceptions, quality of sexual life, and their determinants in elderly women.</p> Methods <p>The study population consisted of 4401 women living in Gediz district. The population of this cross-sectional study consisted of 356 women aged 65&#xa0;years and older living in Gediz District, Kütahya Province, western Türkiye. The data were collected between October 2023 and January 2024 using the personal information form, the Sexual Attitudes Scale for the Elderly, the Gender Relations Scale, and the Women’s Sexual Quality of Life Questionnaire developed by the researcher.</p> Results <p>Of the participants, 85.7% were in the age group of 65–74&#xa0;years, 77.2% were married, 41.6% were primary school graduates, 74.2% did not have a regular income, 94.9% had an income less than their expenses, 57.9% lived with their spouses, and 66.6% had a chronic disease. The results of the regression analysis revealed that the variables of age, educational status, marital status, attitudes toward sexuality, and gender relations affected the scores the participants obtained from the Sexual Quality of Life–Female questionnaire.</p> Conclusion <p>In this study, it was also determined that the participating women’s sexual attitudes significantly affected the quality of their sexual life and that gender roles and relationships had an effect on their sexual life to a certain extent.</p> Policy Implications <p>The findings of this study underscore the necessity for policymakers to recognize sexual well-being as an integral aspect of healthy aging and to incorporate it into national and regional policy frameworks.</p>