Background and Objective: Many couples face challenges in maintaining healthy relationships, leading to decreased quality of life. The purpose of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT)-based couples therapy in enhancing marital quality of life and emotion regulation among distressed couples. Materials and Methods: This quasi-experimental study employed a pretest-posttest design with a control group and a two-month follow-up period. The population for this research consisted of distressed couples seeking counseling and psychological services at centers and clinics in Ahvaz City during the fall of 2023. Forty-eight of these couples were selected using a convenience sampling method and randomly assigned to two groups of 24: an experimental group and a control group. The experimental group received eight 90-minute sessions of ACT-based couples therapy, while the control group received no intervention. Data was collected using marital quality of life and emotion regulation scales. Data analysis was conducted using repeated measures ANOVA in SPSS-25. Results: Results indicated a significant difference between the ACT-based couples therapy group and the control group in terms of marital quality of life and emotion regulation at the post-test (P<0.001). Findings revealed that ACT-based couples therapy led to an increase in marital quality of life and emotion regulation among distressed couples (P<0.001). Conclusions: ACT-based couples therapy was found to be effective in improving marital quality of life and emotion regulation among distressed couples. It is recommended as a potential intervention for couples seeking to address relationship difficulties and enhance their overall satisfaction
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