Background: Sexual satisfaction in marriage is paramount and key to marital satisfaction and happiness. Aims: This study is aimed at determining the prevalence and impact of marital sexual relationship-focused premarital counselling on sexual satisfaction among married women. Setting and Design: A total of 473 married women participated in this cross-sectional survey design; data was generated online utilizing Google form. Method and Material: Sexual satisfaction sub scale of Female Sexual Function Index was used in collecting data. Statistical analysis used: Chi-square and Univariate Analysis of Variance were used in testing the hypotheses in this study at 0.05 significance level. Results: Findings revealed high prevalence of marital sexual relationship focused premarital counselling among married women, with 73.6% of the married women in the study counselled on marital sexual relationship prior to their marriage, χ2 = 105.135, p = 0.0001 ( p < 0.05). Similarly, outcome of hypothesis two revealed significant difference in terms of prevalence of people that render marital sexual relationship focused premarital counselling, with 29.6%, 26.6%, 8.0%, 4.9%, 3.0%, 0.6%, 3.0%, 0.4% and 0.4% respectively, that were educated by pastors, mother, female friend, aunt, grandmother, mothers’ friend, step mother and Imam, χ2 = 540.918, p = 0.0001 ( p < 0.05). Finally, result of hypothesis three revealed that marital sexual relationship focused premarital counselling have significant impact on sexual satisfaction, means; 1.57, 1.44, F (1,471) = 5.923, p = 0.015 ( p < 0.05). Participants that were counselled on marital sexual relationship had mean sexual satisfaction score of 1.57, while those that were not counselled had mean sexual satisfaction score of 1.44. Conclusions: Findings of the study is an implication for marriage counsellors and other professionals that handle marriage related issues to be intentional in addressing marital sexual relationship issues during premarital counselling and there is need to develop marital sexual relationship premarital counselling guide which can help in addressing issues concerning marital sexual relationship during premarital counselling.