Background <p>Spirituality is a significant dimension of marital relationships and family functioning; however, evidence regarding the relationship between perceived spiritual fulfillment between spouses and family harmony in later life is limited. Understanding psychosocial factors that support family harmony is increasingly important in aging populations, yet this relationship has been insufficiently explored among elderly women.</p> Objective <p>This study aimed to examine the relationship between perceived spiritual fulfillment between spouses and family harmony in elderly women.</p> Methods <p>This descriptive and correlational study was conducted with 248 women aged 65 years and older. Data were collected using a Personal Information Form, the Perceived Spiritual Fulfillment Between Spouses Scale, and the Family Harmony Scale. Data were analyzed using descriptive statistics and Pearson correlation analysis.</p> Results <p>Perceived spiritual fulfillment between spouses was strongly and positively associated with family harmony (<i>r</i> = 0.713, <i>p</i> &lt; 0.001). Significant differences in both spiritual fulfillment and family harmony scores were observed according to selected sociodemographic and health-related characteristics (<i>p</i> &lt; 0.05).</p> Conclusion <p>Higher levels of perceived spiritual fulfillment between spouses are associated with greater family harmony in elderly women. This study provides novel evidence highlighting spirituality as an important relational resource in later life and underscores its potential relevance for family-centered and holistic interventions in geriatric care. It is recommended that holistic approaches incorporating the relational dimension of spirituality be considered in interventions and policies for older adults.</p>