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Increased life expectancy creates the prospect of prolonged marital intimacy. However, mature couples face many challenges—physiological, cultural, and familial—and must be able to mobilize individual and relational resources to maintain good levels of marital and sexual satisfaction. The aim of this study is to highlight various factors that contribute to the conjugal and sexual satisfaction of older couples. In total, 534 participants aged between eighteen and seventy-four years old took part, responding to several questionnaires measuring degrees of sexual and conjugal satisfaction, as well as areas of strength and fragility in the relationship dynamics of their couple. In addition, five couples also agreed to take part in semi-structured interviews concerning their relationship dynamics and their view of the aging couple. The results highlight the major impact of several variables contributing to an increase in relational and sexual satisfaction within couples (e.g., health concerns, conflict management, fondness, etc.). Furthermore, a comparison between the scores of the over-fifty-ones and younger participants highlights areas of strengths among older partners. These different factors will be discussed. Finally, we will propose clinical and strategic reflections aimed at supporting areas of strengths among mature couples to support them in achieving long-term relational satisfaction and sexual fulfillment.