Background <p>Sexual self-care and quality of sexual life are critical factors in women’s health. These factors can also influence women’s fertility desire. This study aims to examine sexual self-care, quality of sexual life, and their relationship with fertility desire in women attending comprehensive health centers in Urmia.</p> Methods <p>This descriptive-analytical study was conducted on 384 women which were randomly selected using a multistage sampling method. Data were collected using standard validity and reliability questionnaires of sexual self-care, quality of sexual life and fertility desire. Data were analyzed using one-way ANOVA, independent t-test, and multiple regression.</p> Results <p>The average age of the participants was 32.92 ± 8.03 years. Women’s education level and economic status were significantly associated with fertility desire (<i>P</i> &lt; 0.05). Additionally, sexual self-care (B = 0.490,<i>p</i> &lt; 0.001) and the quality of sexual life (B = 0.232,<i>p</i> &lt; 0.001) were strong predictors of fertility desire. Together, they accounted for 92.8% of the variance in total fertility desire scores.</p> Conclusion <p>Sexual self-care and the quality of women’s sexual life are directly related to the fertility desire. Therefore, Participating in training workshops on body anatomy, menstrual cycle and sexual self-care techniques, providing private counseling sessions to investigate sexual concerns and problems, and providing suitable solutions will help women’s fertility desire.</p>