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Background: Changes in sexual relations are common during pregnancy. These changes may affect couples negatively regarding marital and sexual satisfactions. Objectives: The current study aimed at investigating the effect of a sexual counseling project on females' sexual satisfaction during pregnancy. Methods: The current randomized, clinical trial was performed on a sample of 60 pregnant females referred to the prenatal care clinic of Fatemieh hospital of Hamadan, Iran, in 2014. Females were assigned to the intervention and control groups. A 3-part instrument was used including a demographic information form, an inventory of changes in sexual activities during pregnancy, and the Linda Berg sexual satisfaction scale. The intervention group was divided into 3 subgroups of 10, and each subgroup participated in 4 weekly educational sessions. Descriptive statistics, Chi-square test, the independent samples t test, and paired t test were used to analyze the data. Results: After education, excellent self-evaluation of the quality of sexual relations in the intervention group increased significantly (P < 0.001). The mean sexual satisfaction score of the intervention group significantly increased after the intervention compared with that of before intervention (68.32±12.0 vs. 66.24±12.32, P = 0.029). Among all variables, only the participants' education level had significant correlation with the effect of the intervention on pregnant females' sexual satisfaction. Conclusions: The sexual education program implemented in the current study could significantly increase the females' sexual satisfaction score in the intervention group. [ABSTRACT FROM AUTHOR]