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Objective: The aim of this study was to assess the prevalence and associated factors of female sexual dysfunction (FSD) in Lower Egypt., Design: A cross-sectional clinic-/hospital-based survey., Setting: Five district medical centres in Dakahlia Governorate: Shirbin, Bilquas, Samblawen, Dekrinis and Mansoura City., Population: One thousand married women aged between 16 and 49 years., Methods: Data were collected by personal interview in a questionnaire format in addition to physical examination (when allowed)., Main Outcome Measures: FSD and associated risk factors., Results: The response rate was 93.6%. 68.9% of women had one or more sexual problems; however, 23% of the women with sexual problems were not distressed by these issues. 31.5% of women suffered from dyspareunia. 49.6% of the women had decreased sexual desire, 36% had difficult arousal and 16.9% had anorgasmia (primary and secondary). Marital disharmony, 'hate' and unfavourable socio-economic circumstances were the most common aggravating factors (28.1%) for sexual dysfunction among the participants, followed by pregnancy-related events (15.7%). Most women (84.5%) received no help for their sexual problems. 90.3% of the women were circumcised. Only 7.1% (46 of 645) of women with sexual problems had received treatment, with no real improvement reported in 58.7% (27 of the 46 women)., Conclusions: FSD is a highly prevalent problem within the scope of this study. Low reporting rates and very low treatment rates were identified in the sample from Lower Egypt.