Post-traumatic stress symptoms (PTSS) are a risk factor for using intimate partner aggression (IPA), which has mainly been assessed from the male partner's perspective. In the current study, we compared the rates and levels of using and experiencing psychological IPA as reported by female spouses of men with PTSS. In addition, we examined the mediating role of psychological IPA in the association between men's level of PTSS and female spouses' marital satisfaction. The study was based on 40 heterosexual couples who came for an assessment at a posttraumatic stress disorder couples clinic in Israel. Measures included men's level of PTSS and female spouses' reports on the psychological aggression sub-scale (i.e., using and/or experiencing it) from the conflict tactics scale and the couples satisfaction index. We found high and similar levels of using and experiencing minor psychological IPA. The level of severe psychological IPA was lower and ranged between 5% and 25.6%. The associations between the men's PTSS and the women's relationship satisfaction were fully mediated by severe psychological IPA in a similar path, regardless of whether used or experienced: Namely, higher levels of men's PTSS were associated with female spouses' greater severe psychological IPA which in turn were associated with female spouses' lower relationship satisfaction. The findings support the bidirectional pattern of psychological IPA among couples in which the men have PTSS and its significant role in mediating the association between PTSS and marital satisfaction. Treatment efforts should address the longitudinal dynamic interplay between post-traumatic stress disorder, IPA, and marital satisfaction.