Background: Due to the increasing life expectancy and aging population, attention to general health and marital satisfaction of older people can provide an opportunity to improve their living conditions. Objective: This study aims to assess the general health indicators of older couples to predict their marital satisfaction. Methods: This descriptive cross-sectional study was conducted on 110 older couples (men and women) living in Qazvin, Iran who were selected using two-stage cluster sampling technique. A demographic form, General Health Questionnaire (GHQ) and The ENRICH Marital Satisfaction Scale (EMSS) were used to collect data. Descriptive statistics and multivariate regression analysis were used for data analysis. Findings: The Mean±SD age of older women and men±SD was 64.15±5.46 years and 67.68±6.93 years, respectively. Their Mean±SD EMSS score was reported 109.72±12.58. Multivariate analysis showed that gender (β=0.169, P=0.050), age (β=0.097, P=0.567), age of marriage (β=0.214, P=0.002), somatic symptoms (β=0.233, P=0.013), anxiety/insomnia (β=0.227, P=0.008), social dysfunction (β=0.326, P<0.001), and depression (β=0.356, P<0.001) could significantly predict marital satisfaction. Conclusion: Different dimensions of general health can affect marital satisfaction of older couples. Therefore, interventions in these domains and the promotion of general health level can lead to increased marital satisfaction and, consequently, quality of life in the elderly.