The aim of this study was primarily to investigate the rates of indicative sexual dysfunction (SD) in the last gestational month and at 24 months postpartum. As a secondary objective, we sought to identify the main factors associated with SD at 24 months. The study sample included 131 women who gave birth in maternity wards at two public hospitals in southern Brazil between the period of October 2018 and April 2019. In the first stage (T1), an interview was carried out while the participants were hospitalized, during the immediate postpartum period, based on a clinical record and on the female sexual function questionnaire (Female Sexual Function Index – FSFI). In the second stage (T2), assessments were made via telephone, given the restrictions of the Covid-19 pandemic, 24 months after the initial data collection. At this stage, an updated clinical record was used, followed by the FSFI questionnaire. The final sample consisted of 82 women. Data analysis was performed using descriptive statistics. Data normality was verified using the Kolmogorov-Smirnov test. The chi-square test was used to compare categorical variables in two stages. The Wilcoxon test was used to compare the FSFI score and its domains, both in the last gestational month and at 24 months postpartum. To analyze the correlation of factors associated with the FSFI score, Spearman's test was used. As for sexual function (SF), of the women who were sexually active in the last four weeks of pregnancy (n=33), 39.4% (n=13) indicated SD, while at 24 months postpartum, the percentage was reduced to 20.7% (n=17). There was no statistically significant difference between the total FSFI scores for the two periods observed; however, the analysis of the FSFI domains showed a significant improvement in sexual desire (p=0.01) and a reduction in pain during intercourse (p=0.04) at the 24-month postpartum follow-up. Thus, indications of SD, both in the last month of pregnancy and at 24 months postpartum, can be considered moderate. Furthermore, it was possible to identify factors associated positively, as well as negatively, with SF at 24 months postpartum.