It is well established mastectomy affects a woman’s sexual functioning. However, there is growing recognition that the intrapsychic effects of mastectomy, such as changes to one’s body-image and physical integrity can threaten embodied experiences and gendered identity. This is seen to alter how a woman appraises her sense of femininity; influencing her engagement in sexual activity and impacting upon intimate relationships. Accordingly, the aim of this review was to explore and elaborate the impact of mastectomy upon a woman’s sexuality through a synthesis of relevant qualitative literature. A systematic literature search of five databases (Academic Search Complete, CINAHL, PsychARTICLES, PsychINFO, and MEDLINE) was undertaken using terms for mastectomy, sexuality, and qualitative data. A meta-synthesis was conducted on the data from the twelve studies obtained. Three overarching themes were derived highlighting how mastectomy impacts upon a woman’s femininity, sense of personal attractiveness and desirability within intimate relationships, and the importance of an intimate partners support in enabling women to adjust to their altered bodies. Findings have important practice implications. Particularly, the need for clinicians to offer interventions that aim to maintain the relationship between a woman, her altered body, and partner after mastectomy.