This study aimed to investigate the medical and obstetric determinants of sexual dysfunction among postpartum women in Rivers State. Using a descriptive research design, the study targeted a population of 2,670,903 postpartum women, with a sample size of 1,200 selected through a multi-stage sampling procedure. Data were collected using the adapted Female Sexual Function Index (FSFI) questionnaire, which demonstrated a reliability coefficient of 0.856. Statistical analysis was conducted using SPSS version 23.0, applying linear and multinomial logistic regression at a 0.05 alpha level. The results revealed a statistically significant relationship between sexual dysfunction and key determinants, including mode of delivery (p<0.05), history of hypertension (p<0.05), and history of diabetes (p<0.05). Notably, the study found that 98.9% of women who had undergone a Cesarean section reported sexual dysfunction, with similar high prevalence rates observed among hypertensive (100%) and diabetic women (98.0%). The findings suggest that the mode of delivery, and a history of hypertension and diabetes, are significant determinants of sexual dysfunction among postpartum women in Rivers State. The study concludes by recommending the establishment of specialized sexual health units within healthcare facilities to address these issues and improve the sexual health and well-being of postpartum women in the region