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Abstract Purpose Child marriage remains a significant socio-cultural phenomenon with profound implications for the quality of marital relationships, particularly among young women. This study investigates the association between child marriage and the quality of marriage among young married women in Iran. Methods This study employed a population-based cross-sectional research design. A total of 70 young women, aged 18–20 years, who had married before reaching 18 years of age, were selected from four primary health care (PHC) centers in Papi District, Lorestan Province, Iran, employing a systematic random sampling approach. Subjects were categorized into women experiencing relationship distress and those without such distress using the Quality of Marriage Index (QMI). Concurrently, their level of sexual satisfaction was assessed utilizing the Hudson’s Index of Sexual Satisfaction (ISS). Furthermore, Social Support was evaluated using the Social Support Questionnaire (SSQ). Results The mean age (SD) of women was 18.9 (0.7) years, and their mean age (SD) of marriage was 15.2 (2.1) years. Women experiencing distress showed significant differences in age of menarche (P = 0.006), education levels (P = 0.039), spouses’ education (P = 0.025), spouses’ occupations (P = 0.004), household income satisfaction (P = 0.041), and household structure (P = 0.045). Pearson’s correlation coefficient analysis revealed significant and positive correlations between sexual self-efficacy and social support with marital quality (r = 0.73, p