PURPOSE: Preterm birth (PTB) is a major problem in the United States, and black women have greater risk of PTB than white women. The etiology of PTB and the racial disparity in preterm outcomes are poorly understood. Diminished life satisfaction is associated with adult health, but there are no studies of life satisfaction and PTB. In the research reported in this article, the relationship between life satisfaction and PTB among black women was studied. METHODS: Women were enrolled in this prospective study at the time of the first visit to 5 prenatal clinics in Baltimore. Life satisfaction was assessed at the time of the first prenatal visit. Data on PTB were obtained from medical records. RESULTS: The final sample consisted of 922 women. Among women who were somewhat or not at all satisfied with their lives, 16% had preterm births, whereas among women who were very satisfied with their lives, 10.7% had preterm births (unadjusted odds ratio = 1.6; 95% CI 1.1-2.4). The adjusted odds ratio was 1.6 (95% CI 1.00-2.5). CONCLUSIONS: Women who reported being somewhat or not at all satisfied with their lives had a greater risk of PTB than women who reported being very satisfied with their lives.