The Asia-Pacific Sexual Health and Overall Wellness (AP SHOW) survey assessed sexual satisfaction and health and the association with erection hardness in 13 Asia-Pacific countries/regions. Adults aged 25-74 years who had sexual intercourse > 1 time in the past 12 months answered Internet surveys or participated in street-intercept interviews. Data were weighted by demographics and country/region size. Of 3957 (men, n=2016 and women, n=1941) respondents, 41% of men and 34% of women were completely or very satisfied with sex. Satisfaction with sex was linked to satisfaction with life priorities and overall health. Few respondents (men, 38% and women, 26%) were very or completely satisfied with erection hardness. Optimal erection hardness was reported by 45% of men (48% of women regarding their partners' erections). Erection hardness was associated with increased frequency of sex and importance of and satisfaction with erection-related elements of men's sexual performance. Approximately half of respondents (men, 57% and women, 47%) were at least moderately interested in improving the sexual experience. Most Asia-Pacific respondents were less than very satisfied with sex. Satisfaction with sex was associated with satisfaction with life priorities. Erection hardness was associated with sexual satisfaction and activity, satisfaction with life priorities and overall health.