Abstract :Female sexuality is complex and highly contextual, influenced by among others one’s body image and self-esteem. Body image experiences are integral to the quality of an individual’s life including sexual function. Research findings have linked evaluations and cognitions interference with sexual responses and experiences during sexual activity. They may lead to sexual dysfunction, sexual aversion, avoidance and risky sexual behaviors. This paper presents four young Black African women with poor body image of different parts of the body namely the breasts, weight and configuration and external genitalia, and impact thereof on their sexual functioning. One had reconstructive cosmetic surgery and was subsequently satisfied with the results. The others were counseled and supported to accept who they were, two of whom made significant improvement. The potential impact of body issues on reproductive health care delivery in the context of a developing country is discussed. With the changing socio-cultural, demographic, lifestyles as well as increasing information dissemination due to technological advances, these concerns are likely to increase, compounded by an increase in sexual functioning problems, with an inevitably heightened demand on health service delivery. Health care providers and in particular gynecologists need to be aware thereof, so that they may offer appropriate counseling, care and support to women seeking their help. Women need to be assured that their bodies are fine the way they are, and their male partners appraised on the need to appreciate and respect their female partners and not deride them on account of body or body-part appearances.