Objective: To compare the sexual function of women with female genital mutilation (FGM) to women without FGM. Design: A prospective case-control study. Setting: A tertiary referral university hospital. Patient(s): One hundred and thirty sexually active women with FGM and 130 sexually active women without FGM in Jeddah, Saudi Arabia. Intervention(s): Women with and without FGM were asked to answer the Arabic-translated version of the female sexual function index (FSFI) questionnaire. Main Outcome Measure(S): The individual domain scores for pain, arousal, lubrication, orgasm, satisfaction, pain, and overall score of the FSFI were calculated. Result(s): The two groups were comparable in demographic characteristics. There were no statistically significant differences between the two groups in mean desire score ( standard deviation) or pain score. However, there were statistically significant differences between the two groups in their scores for arousal, lubrication, orgasm, and satisfaction as well as the overall score. Conclusion(s): Sexual function in women with FGM is adversely altered. This adds to the well-known health consequences of FGM. Efforts to document and explain these complications should be encouraged so that FGM can be abandoned. (Fertil Steril (R) 2010;93:722-4. (C)2010 by American Society for Reproductive Medicine.)