Background: Infertility is a grave concern accompanied with many negative consequences varying from emotional, psychological problems and social stigmas, especially for women. Objective: This study evaluated the relationship between psychological distress Depression Anxiety Stress (DAS) of primary infertile Omani women, and their perceived social support and couple adjustment. Methods: This descriptive cross-sectional study consisted of 306 primary infertile Omani women visiting infertility clinics at Sultan Qaboos University Hospital, Royal Hospital, and Wattayah policlinic between July and December 2022. Data for the research was gathered through questionnaires to determine participant’s demographic data, Depression, Anxiety and Stress (DAS), Perceived Social Support (PSS), and Couple Adjustment. Results: In the study, the average age of primary infertile women was 32±5.86 years with 6.40±4.34 years of marriage and 5.86±4.17 years of infertility. Infertile women reported moderate to severe levels of total depression, anxiety, and stress (39.6%). Also, they perceived low levels of social support (95.8%) and high levels of couple adjustment (66.3%). Inferential statistics revealed a significant and strong negative correlation between depression, anxiety, stress, and perceived social support among participants. Significant strong positive correlation was found between couple adjustment and perceived social support, as well as with some of demographic characteristics such as age of women and the following variables: infertility duration, marriage duration and treatment duration. Finding also revealed that infertile women with high levels of education perceived more social support. Women with low family monthly income had high level of depression, anxiety, and stress. Also, participants with low family monthly income perceived low couple adjustment. Participants with high levels of education were found to have had more couple adjustment levels, and participants with less family income had less couple adjustment (distress) and mainly in the cohesion subscale of couple adjustment. Conclusion: As a result of the current study, to decrease psychological distress, Depression, Anxiety and Stress (DAS) among infertile women attending infertility clinics, couple adjustment levels, and social support levels perceived by infertile women should be increased. In other words, perceived social support and couple adjustment in marriage among women experiencing primary infertility are important factors in releasing their psychological distress. The results of this study highlight the need for social and familial awareness to help tackle the psychological distress related to infertility.