Background: Middle adulthood is the time of life between ages 40 and 65. During this time, people's sexuality changes. The physical transformations body undergoes as age have a major influence on your sexuality. Declining hormone levels and changes in neurological and circulatory functioning may lead to sexual problems. Therefore, the goal of the current study is to assess the efficacy of nurse-driven client-centered behavioral therapy intervention on sexuality in middle adulthood. Methods: The research approach adopted for the study was a true experimental design. The selection of subject was done by the Purposive Sampling technique method and the sample consists of 60 middle adults residing in Achankuttapatty, Salem, Tamil Nadu. The data was collected by administering Multidimensional Sexuality Questionnaire (MSCQ) questionnaires The validity and reliability of the tool were obtained. The collected data were analyzed by using descriptive and inferential statistics in terms of Frequency, Percentage distribution and chi-square test, and independent ‘t-test. Results: the majority of the sample group were 40-50 old, were male, had primary education, work profile of temporary employment, and earn below 10000 per month. there was a statistical significance was noted in the independent t-test between pre and post-test mean scores. it was found that the efficacy of nurse-driven client-centered behavioral therapy intervention on sexuality among middle adulthood was statistically significant.