The purpose of the study is to assess the relationship between sexual satisfaction and gender, perception of body image, and level of self-esteem in college students in southern Taiwan. This study conducted questionnaires completed by 637 college students in southern Taiwan. The questionnaire consisted of four sections: the Personal Background Survey, the Multidimensional Body-Self Relations Questionnaire, the Rosenberg Self-esteem Scale, and the Sexual Satisfaction Inventory. Statistical analysis used in the study included descriptive statistical, t-test, Pearson correlation, and stepwise multiple regression. Major findings of this study are as follows: 1. In perception of body image, level of self-esteem and sexual satisfaction are between medium and high in college students in southern Taiwan. 2. Evaluation of appearance and body satisfaction in male was significantly higher than female; orientation of appearance in female was significantly higher than male and sexual satisfaction in male was significantly higher than female. There was no significant difference between male and female in self-esteem. 3. The positive relationships were found to be significant in college students in southern Taiwan between perception of body image and self-esteem, perception of body image and sexual satisfaction, and self-esteem and sexual satisfaction. 4. Gender, perception of body image, and self-esteem were the main predictors for sexual satisfaction in college students in southern Taiwan. The researcher sincerely hopes that this study can provide the consulters in colleges some ideas in regards to students' body image, self-esteem, and sexual satisfaction, which in turn can help them resolve students' sex problems in the future.