Background: Spinal cord injury (SCI) is a life-altering experience that affects sexuality as well as other aspects of an individual’s life. However, sexuality of women with SCI has received less attention than that of men. Objectives: This study focused on the sexual understanding of a sample of Iranian women with SCI. Methods: This qualitative study was conducted with 24 semi-structured interviews. Women with SCI were recruited from the brain and spinal injury research center (BASIR) registry system at the Imam Khomeini hospital in Tehran, Iran. Barun and Clarke’s thematic analysis approach was adapted to analyze the narrative data. Results: According to participation viewpoints, the following three main themes were explored: the dilemma that lead to limited sexual activity, seeking positive sexual adjustment, and the lack of client-based sexuality education in the rehabilitation process. Conclusions: Our findings revealed that women with SCI expressed a need to be recognized as capable sexual beings regardless of their disability. The narratives highlighted their desire to seek help in order to prevent the adverse impact of SCI on their sexuality and marital life. These women could seek an active and pleasurable sexual life if they are informed about sexuality changes postinjury, accept sexual behavior changes, and apply various sexual skills to their post-injury lives. Therefore, sexuality education and counseling soon after SCI is recommended. These services would be delivered by a rehabilitation team to women and their spouses during initial caregiving and be ongoing as long as needed.