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There is emerging evidence for the efficacy of mindfulness-based interventions for improving women’s sexual functioning. To date, this literature has been limited to self-reports of sexual response and distress. Sexual arousal concordance—the degree of agreement between self-reported sexual arousal and psychophysiological sexual response—has been of interest due to the speculation that it may be a key component to healthy sexual functioning in women. We examined the effects of mindfulness-based sex therapy on sexual arousal concordance in a sample of women with sexual desire/arousal difficulties (n = 79, M age 40.8 years) who participated in an in-laboratory assessment of sexual arousal using a vaginal photoplethysmograph before and after four sessions of group mindfulness-based sex therapy. Genital-subjective sexual arousal concordance significantly increased from pre-treatment levels …