Improving women’s sexual and reproductive health has been the focus of decades of public health programs and interventions in sub-Saharan Africa. The majority of women’s risk for sexual and reproductive health problems occurs within the context of marital or long-term partner relationships. Drawing on primary data collected from an unplanned settlement outside Lusaka, Zambia, this chapter explores the connections between the nature of a woman’s partner relationship and sexual and reproductive health. Findings indicate that for women who are married or in long-term partner relationships, the nature of their primary partner relationship plays a critical role in both their sexual and reproductive health. In general, a positive partner relationship was associated with better reproductive and sexual health. Women in relationships where they experience gender-based violence (GBV), poor communication and limited support from their partners are at greater risk for sexual and reproductive health problems. For women in marital or long-term partner relationships, the nature of the relationship with their primary partner is a significant variable in their sexual and reproductive health outcomes. Therefore, in order to have a significant impact programs and interventions aiming to reduce women’s sexual risk and improve their reproductive health outcomes must also target women’s primary male partner.