Objective: We examine how sexual activity relates to sexual well-being within the context of sexual attitudes, sexual agency, and sexual desire. Participants/Methods: We surveyed 471 college women in 2012-2014 who had ever had sex. Results: Sexual agency and sexual desire consistently predicted well-being, regardless of recent sexual activity. There was a significant interaction between recent sexual activity (none, casual, or exclusive relationship) and sexual attitudes. Exclusive sex was associated with higher than average sexual well-being, especially for women with permissive attitudes. Women who had casual sex and held permissive to average attitudes had the next highest levels of well-being, but those with non-permissive attitudes fell substantially below the overall mean. Women who had no recent sex were consistently below the mean, especially for women with more permissive attitudes. Conclusions: A disconnect between sexual attitudes and recent sexual activity may lower women's sexual well-being.