There is little information on the impact of pain on sexual health in later life. The aim of this analysis was to determine the association between self-reported pain and sexual health in older men and women. Data were collected for the nationally representative English Longitudinal Study of Ageing. Community-dwelling adults aged 50 years and older completed the Sexual Relationships and Activities Questionnaire in Wave 6 (2012/2013). Participants were asked (waves 1-6 [2002-2013]) whether they were “often troubled with pain” and, how severe was their pain; mild, moderate, or severe. The association between pain and sexual health was assessed using logistic regression. Analyses were stratified by sex, with adjustments made for age followed by adjustments for health and lifestyle factors, depressive symptoms, and socioeconomic status. Of the 3916 participants who reported having sexual activity in the past year, 28% of women and 23% of men reported experiencing moderate or severe pain often at Wave 6. After adjusting for age, compared with men experiencing no pain, men with moderate or severe pain reported less frequent intercourse and masturbation, more erectile difficulties, and more concerns about their sexual health. After age adjustment, there were no associations between pain severity and sexual health among women. Of the 1872 participants with a cumulative pain score, there were significant associations between reporting pain and concerns about sexual health in both men and women. Pain was associated with impairment in sexual health in men and women; however, the effect was more marked in men.