While the physical impact of ankylosing spondylitis (AS) is central to clinical treatment, the sexual problems associated with AS are often overlooked. Sexual problems may be related to a variety of undocumented demographic parameters, physical impairments, and psychological problems. These associations were examined through a single-center cross-sectional study of 103 AS patients (78 males and 25 females) and 121 healthy individuals (73 males and 48 females). All participants provided information pertaining to sexual problems, sociodemographics, and clinical characteristics via written questionnaires including multiple-choice questions conducted independently in the clinical setting under physician supervision. Rates of both prevalence and severity of sexual dysfunctions in AS patients were much higher than those observed in healthy individuals. Bath Ankylosing Spondylitis (BAS) Disease Activity Index and two parameters of body image disturbance (distress and impairment in social functioning) correlated with impaired partner relationships (P < 0.05). BAS mobility index, impaired social functioning, and BAS functionality index were the most significant causes of impaired sexual function (P < 0.05) in AS patients. Both physical and psychological factors were shown to impact sexual relationships and function in Chinese AS patients. To more effectively manage AS in clinical settings, rheumatologists and nursing specialists should be aware of the condition's impact on sexual health, considering both physical outcomes, such as disease activity and physical function, as well as psychological well-being.