Abstract Introduction Discrepancies in partners’ levels of sexual desire (SDD) are common in long-term relationships and can be experienced as distressing. Because sexual compatibility is a strong prescriptive among Western couples, it is relevant to examine the sexual and relational implications of SDD in relationships that are marked by cultural restrictions and gender stereotypic norms. Objective We examined discrepancies in sexual desire between partners and assessed how such discrepancy relates to sexual and relational functioning, taking into account both partners’ attachment orientation Methods 100 couples of which more than half experienced sexual problems completed an Arabic version of questionnaires on sexual desire, sexual function, sexual satisfaction, relationship satisfaction and attachment orientation. Results Men and women reported better sexual function, sexual satisfaction, and relational satisfaction when they matched on higher levels compared to lower levels of sexual desire. In case there was a mismatch between partners, women reported higher sexual satisfaction when their partner’s level of sexual desire was higher than their own desire. Attachment orientation was found to moderate the associations between the degree and direction of SDD and the outcome variables. Male attachment avoidance moderated the association between SDD and both male and female sexual function. Male attachment anxiety moderated only the association with female sexual function, indicating that women with high anxious partners reported better sexual function when their partner’s level of desire was higher than their own desire. In addition, the female attachment dimensions moderated the association between SDD and female satisfaction outcomes, with attachment anxiety moderating the association with sexual satisfaction and attachment avoidance moderating the association with relational satisfaction. Conclusions We showed the importance of considering both the level and direction of SDD and the partners’ attachment history to understand its sexual and relational implications. Therapeutic interventions should be directed at understanding the attachment meaning of sexual desire, facilitators and barriers of sexual desire across time and context, and the reasons why some couples cope better with SDD than others. Disclosure No.