Dissatisfaction with one's body image is widespread and can have serious health consequences; however, research about its prevalence and correlates in older women is limited. We analyzed data from 75,256 women participating in the Women's Health Initiative Observational Study, a longitudinal study of postmenopausal women's health. Measures used in the study were collected at baseline and/or the third year of follow-up between 1993 and 2002. The majority of participants (83%) in this study were dissatisfied with their bodies because they perceived themselves as heavier than their ideal. Overall, the multiple and significant correlates of body image dissatisfaction explained 36.2% of the variance in the body image dissatisfaction score, with body mass index (BMI) and change in BMI being the two most important contributors to explaining the variance. The results of this study suggest future research should focus on the utility of interventions to reduce dissatisfaction with body image in postmenopausal women that target either maintenance of a lower BMI through diet and exercise, and/or body acceptance. Further, future research should aim to identify factors in addition to body size that drive body image dissatisfaction.