Background <p>Sexual self-care is an emerging concept in reproductive health. In addition to harm reduction, self-care plays a key role in promoting physical, mental, and social health, especially in societies where sexual taboos exist. This study aims to compare the sexual self-care among fertile and infertile women in Ardabil city.</p> Methods <p>This cross-sectional study included 100 fertile women visiting health centers and 100 infertile women from the Ardabil Infertility Treatment Center, aged 15–49 years, between May 2024 and February 2025. Samples were selected through convenience sampling based on inclusion criteria. Data were collected using a demographic questionnaire and Female Sexual Health Self-care (FSHS) questionnaire, and analyzed in SPSS version 26 using chi-square test, independent t-test, and ANOVA.</p> Results <p>Female and male factors were reported as causes of infertility in 59% and 41%, respectively. The mean self-care score of the fertile group was 57.93 ± 15.42 and for the infertile group was 60.62 ± 13.14. There was no significant difference in overall sexual self-care scores between the two groups, but when source of health-related information was considered as a confounding factor, the results related to total score of the instrument became significant (p-value = 0.04). The highest score in both groups was related to the domain of sexual health promotion, with a higher mean score of infertile women (76.13 ± 15.66) compared to the fertile group (62.09 ± 19.83), and there was a significant difference between the two groups (<i>p</i> &lt; 0.001).</p> Conclusion <p>The findings of this study indicated that there is no significant difference in sexual self-care between fertile and infertile women, despite variations in sources of health-related information. Therefore, it can be concluded that sexual self-care is a multidimensional phenomenon influenced by various factors and cannot be explained solely based on fertility status.</p>