This article describes the design and implementation of a group couples' intervention focused on improving women's sexual health as a component of a multilevel community, clinical, and counseling intervention project conducted in association with a gynecological service in a municipal urban health center in a low‐income community in Mumbai, India. The group couples' intervention involved four single‐gender and two mixed‐gender sessions designed to address the dynamics of the marital relationship and establish a more equitable spousal relationship as a means to improve women's sexual and marital health. Involvement of men presented a major challenge to couple's participation. For those couples that did participate, qualitative findings revealed significant changes in couple and family relations, sexual health knowledge, and emotional well‐being.