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Sexuality has an important impact on people's physical and mental health, but current research on the sexual activity of older Chinese women has many limitations and more detailed studies are needed. The objective was to determine the prevalence of sexual activity and related factors in women aged 55 to 85 years in Hunan, China. Based on the data from the Hunan Provincial Women Health Needs Survey in 2018, we conducted a secondary analysis of 2,401 older women aged 55 and above. The dependent variable was sexual activity, and independent variables included sociodemographic characteristics, health behaviors, reproductive and chronic medical history, and psychological characteristics. All statistical analyses were performed using SPSS 26.0. Chi-square test was used to assess the association between categorical variables, and binary logistic regression was used to examine factors related to sexual activity. Sexual activity and related factors. The prevalence of sexual activity among older women was 12.5% (301/2401) in the past month. Having a partner (OR = 1.484; 95% CI, 1.048-2.101; P =.026), jogging (OR = 2.061; 95% CI, 1.391-3.054; P <.001), dancing (OR = 1.477; 95% CI, 1.106-1.974; P =.008), vegetarian-based diet (OR = 2.197; 95% CI, 1.334-3.618; P =.002), meat-based diet (OR = 2.196; 95% CI, 1.144-4.216; P =.018) were positively associated with being sexually active. Whereas, aging (OR = 0.781; 95% CI, 0.647-0.942; P =.010), living in the urban (OR = 0.628; 95% CI, 0.488-0.808; P <.001), hypertension (OR = 0.702; 95% CI, 0.520-0.949; P =.021), and anxiety (OR = 0.680; 95% CI, 0.475-0.972; P =.034) were negatively associated with being sexually active. Health care workers need to be aware that older women still have sexual activity and understand the needs of older women for sex education, take the initiative to discuss safe sex with them, and solve their sexual problems. This is one of the largest studies to determine the prevalence of sexual activity among older women in China and its related factors. In addition, new factors such as exercise types and eating habits related to sexual activity were discovered. The limitation of this study is that it did not use a specific questionnaire to assess the sexual activity and did not consider physical tenderness other than sexual intercourse. Some older women still have had sexual activity in the past month and factors such as lifestyles that can be changed and chronic diseases that can be self-managed were found to predict sexual activity. Li T, LuoY, Meng Y, et al. Sexual Activity and Related Factors of Older Women in Hunan, China: A Cross-Sectional Study. J Sex Med 2022;19:302–310. [ABSTRACT FROM AUTHOR]