<p>In this descriptive, correlational study, the aim was to investigate the effect of body image on sexual attitudes in pregnant women. The study was conducted with 460 pregnant women who attended the Pregnancy School of a Training and Research Hospital in Turkey between March 2025 and July 2025. Data were collected using the Descriptive Characteristics Form, Body Understanding Measure for Pregnancy Scale (BUMPS), and Attitudes towards Sexuality in Pregnancy Scale (ASPS). Pearson correlation was used to analyze the relationships between continuous variables, and the multiple linear regression analysis was used to determine the factors affecting attitudes towards sexuality using backward elimination. The mean age of the participants was 28.42 ± 5.04 years. The largest proportion held a bachelor’s degree, and a substantial proportion of their spouses also had a bachelor’s degree. The mean score the participants obtained from the ASPS was 123.50 ± 20.06, above the cut-off point (111.5); indicating that the <i>participating pregnant women’s</i> (hereafter referred to as “participants”) attitudes towards sexuality were generally positive. The mean score they obtained from the BUMPS score was 50.91 ± 11.87, indicating that they had a moderately positive body image. The results of the multiple linear regression analysis revealed that the educational status of the participants and their partners, and certain pre-pregnancy and pregnancy-related factors significantly affected the participants’ attitudes towards sexuality during pregnancy. In conclusion, as the participants’ acceptance of their body image increased and their concerns about weight gain decreased, they displayed more positive attitudes towards sexuality. It is recommended that nurses should be encouraged to plan supportive interventions that address pregnant women’s body image and attitudes towards sexuality.</p>