Endometriosis affects women of reproductive age. Besides the physical limitations of the illness, such as dyspareunia and pelvic pain, it infiltrates other aspects of women's life inclusive of psychological difficulties, sexual difficulties, and relational distress. Despite the relational context of endometriosis, interpersonal goals have not been studied in couples living with endometriosis. Through a dyadic lens, the current study aimed to examine the role relationship goals play in psychological health, sexual and relationship satisfaction, and sexual distress for couples living with endometriosis. Utilising a cross-sectional design, 61 couples completed an online survey including measures of relationship satisfaction, sexual satisfaction, depressive, anxious, and stress symptoms, and sexual distress. The study results indicated that, for women, their own and their partners' relationship approach goals influenced their sexual satisfaction and their partners' relationship avoidance goals increased their sexual distress. For partners, their own relationship approach goals increased their relationship satisfaction and women's low sexual distress increased their sexual satisfaction. Relationship avoidance goals in both women and partners increased relationship satisfaction. Severe symptoms of depression and anxiety were evident for women and mild symptoms seen in their partners. High sexual distress was observed in both members of the couple. The study's findings implicate interpersonal goals as relevant to the relational and sexual experience of couples living with endometriosis. Furthermore, endometriosis negatively impacts on the couples' relationship, psychological, and sexual wellbeing. When treating women with endometriosis, the inclusion of partners and consideration of factors beyond the physical illness are crucial to the holistic management of endometriosis.