Sleep disturbance negatively affects sexual function. Sleep problem and sexual dysfunction are common in methadone-maintained patients; however, their association is understudied in this patient population.This study examined the association between sleep quality and sexual satisfaction in Chinese patients receiving methadone maintenance treatment (MMT).This was a cross-sectional study. A total of 480 MMT patients who had sex with their sex partners within 1 month before the survey were recruited from 3 MMT clinics in Wuhan, China. Sexual satisfaction was assessed with a single question, and sociodemographic and clinical data were collected with a standardized questionnaire. Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Multiple ordinary logistic regression was used to control for potential confounders that may bias the sleep-sexual satisfaction relationship.Sexual satisfaction scores were significantly higher in poor sleepers than normal sleepers (3.2 ± 0.9 vs. 2.8 ± 1.0, t = 4.297, P < .001). After controlling for potential confounders, results of the multiple regression analysis reveal that poor sleep quality was still significantly and independently associated with low sexual satisfaction (odd ratio = 1.58, P = .009).Poor sleep quality is significantly associated with low sexual satisfaction of methadone-maintained patients. Improving sleep quality might improve sexual satisfaction of patients receiving MMT.