Background: A hysterectomy has a devastating impact on women's life . Aim: To evaluate the effectiveness of a Counseling Supportive Program on improving sexual quality of life and reducing depression levels in hysterectomy women. Design A randomized controlled design was employed. Setting The study was conducted at the gynecology outpatient clinic of El-Mansoura University hospital. Sample 58 hysterectomy women were selected through simple random sample, divided into two equal groups, with data collected between November 2023 and April 2024. The program began post-discharge, with follow-up visits after 2 and 4 months. Data Collection Tools Three tools were used: Structured Interviewing Questionnaire: Socio-demographic data and sexual relations health. Patient Health Questionnaire: Assessing depression levels and self-reported sexual quality of life. Knowledge and Practice Tools: Nutrition, fluid intake, sleep patterns, pelvic floor muscles, and deep breathing exercises. Results: Pre-Program: 75.9% had low sexual quality of life, 48.3% had high depression, and 34.5% had poor self-practice. Post-Program: Significant improvements (p = 0.001) in knowledge and self-practice. Conclusion : The Counseling Supportive Program significantly improves sexual quality of life and reduces depression among hysterectomy women compared to the control group. Recommendations: Counsel and rehabilitate couples on sexual concerns, healthy sexual behaviors, and conduct larger studies for nationwide results.