PURPOSE The aim of this study was to identify factors affecting the perception of sex life and sexual desire coping behavior among the spouseless elderly. METHODS The participants were 149 elders who resided in six administrative regions of B city. Data were collected from December 1, 2012 to March 3, 2013 using a questionnaire. Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffe test, Pearson's correlation coefficient, and Stepwise multiple regression in a PASW 18.0 program. RESULTS Stepwise multiple regression analysis of data indicated that the most likely predictor is gender. Gender, sexual relation, subjective health status and parent-child relationship explained 34% of the variance of perception of sex life. Gender, dating status and age explained 44% of the variance of sexual desire coping behavior. CONCLUSION Based on the study findings, gender and current dating status should be considered to conduct comprehensive sex health care education for healthy sex life of the elderly with no spouse.