Background/Objectives: Urinary incontinence (UI) significantly affects women’s health worldwide, but its specific prevalence in Ecuador is not well documented. This research aimed to determine the prevalence of urinary incontinence among sexually active women in the Cuenca canton and the factors associated with its presence. Methods: A descriptive cross-sectional study was conducted from August 2023 to January 2024 involving 460 women aged 30 years or older attending public health centers in Cuenca, Ecuador. The ICIQ-SF questionnaire was used to assess the presence and severity of UI and its impact on quality of life, along with a data collection form. Results: The findings revealed that UI is prevalent in a population that often lacks timely diagnosis, further obscuring the true extent of the issue. The results demonstrated that sociodemographic, gyneco-obstetric, and urological factors significantly influenced the risk of developing this condition. Conclusions: This study demonstrated a high prevalence of UI among women in Cuenca, Ecuador, with a notable impact on quality of life. The aforementioned factors predispose to the development of this condition, highlighting the need for preventive and rehabilitative interventions, as well as appropriate policies to address UI as a public health issue.