Most research on intertemporal choice has examined choices between smaller, sooner gains and larger, later gains. A much smaller number of papers have examined intertemporal choices for losses. In this article, we explore whether mixed-sign choices with both gains and losses may better correlate with real-world behaviors. In two high-powered studies (pilot: N = 3,200; main study: N = 7,000), participants completed one of four normatively equivalent measures consisting of pure gain, pure loss, or mixed sign (Gain-Now-Loss-Later or Loss-Now-Gain-Later) intertemporal choices. Participants also self-reported a large number of demographic measures and real-world choice behaviors thought to be linked to intertemporal choice. The results indicate that (1) mixed-sign intertemporal choices yield more patient time preferences than pure-gain choices but less patient than pure-loss choices and (2) pure-gain intertemporal choices yield equivalent or superior predictive power across a range of real-world intertemporal choice behaviors.