OBJECTIVE Postpartum dyspareunia has been attributed by authors of obstetric texts to episiotomy tenderness or vaginal atrophy. The nursing literature attributes it to low estrogen levels. This study attempts to examine these assumptions, to clarify the incidence of postpartum dyspareunia and the length of time it is likely to last. STUDY DESIGN Sixty-two women in a private practice were examined between two and eight weeks postpartum and followed prospectively. RESULTS Forty-five percent of parturients developed entry dyspareunia, but only 6% had pain at the sites of vulvar repair. The median length of symptoms in the 39% with nonfocal introital dyspareunia was 5.5 months, and tenderness lasted up to 1 year. Such dyspareunia developed in women having a first (42%) or second (47%) infant, delivering vaginally (42%) or by cesarean section (29%), and lactating (41%) or not lactating (22%). One-third of those affected had severe sexual dysfunction. CONCLUSION Postpartum dyspareunia is quite common and can be a significant source of difficulty in the months after delivery. It is an underdetected problem and deserves more study.