Purpose: This study was conducted to identify the relationship of spirituality and self-esteem in middle-aged women. Methods: The participants were 260 women, aged 40 to 64, living in Busan City or Kyungnam Province. The measurement scale used in the study were the ``Korean Spirituality Scale`` and a ``Self-esteem Scale``. The collected data were analyzed using t-test, ANOVA, Pearson` correlation coefficients, and simple linear regression with the SPSS/WIN 20.0 program. Results: The level of spirituality and self-esteem of the women averaged 3.1. For differences in spirituality and self-esteem by general characteristics, there were significant differences according to religion, employment, and economic status. There was a significantly positive correlation among spirituality and self-esteem. Simple linear regression analysis showed that spirituality accounted for 49% of the variance in self-esteem. Conclusion: The interest in spirituality is an important in psychological nursing to meet patient demands, especially patients who are experiencing existential problems. It is necessary to provide psycho-spiritual programs for the middle-aged women to improve self-esteem. Future research with experimental designs and random sampling needs to be done to examine relationships between middle-aged women`s spirituality and self-esteem.