AbstractThe hypothesis that an initially severe level of marital dissatisfaction limits responsiveness to sex therapy was tested. As part of a larger investigation of the predictive utility of certain patient characteristics for sex therapy outcome, 15 married couples who underwent an average of 15 sessions of conjoint treatment for sexual dysfunction completed a marital adjustment scale and a constellation of outcome measures. Support for the hypothesis was mixed. Individuals reporting milder and more severe levels of marital distress manifested equivalent levels of relationship enhancement on the Sexual Interaction Inventory. However, therapists' and, to a lesser extent, patients' posttreatment ratings indicated that more satisfied spouses of both sexes registered greater improvement on both sex‐specific and more generic outcome criteria. Although the results leave open the overall question of a linkage between initial level of marital satisfaction and responsiveness to sex therapy, they suggest the potential fruitfulness of more definitive inquiry.