Abstract Background Research demonstrates significant gender- and sexual orientation–based differences in orgasm rates from sexual intercourse; however, this “orgasm gap” has not been studied with respect to age. Aim The study sought to examine age-related disparities in orgasm rates from sexual intercourse by gender and sexual orientation. Methods A survey sample of 24 752 adults from the United States, ranging in age from 18 to 100 years. Data were collected across 8 cross-sectional surveys between 2015 and 2023. Outcomes Participants reported their average rate of orgasm during sexual intercourse, from 0% to 100%. Results Orgasm rate was associated with age but with minimal effect size. In all age groups, men reported higher rates of orgasm than did women. Men’s orgasm rates ranged from 70% to 85%, while women’s ranged from 46% to 58%. Men reported orgasm rates between 22% and 30% higher than women’s rates. Sexual orientation impacted orgasm rates by gender but not uniformly across age groups. Clinical Translation The persistence of the orgasm gap across ages necessitates a tailored approach in clinical practice and education, focusing on inclusive sexual health discussions, addressing the unique challenges of sexual minorities and aging, and emphasizing mutual satisfaction to promote sexual well-being for all. Strengths and Limitations This study is the first to examine the orgasm gap with respect to age, and does so in a large, diverse sample. Findings are limited by methodology, including single-item assessments of orgasm and a sample of single adults. Conclusion This study revealed enduring disparities in orgasm rates from sexual intercourse, likely resulting from many factors, including sociocultural norms and inadequate sex education.