Medico-Legal Evaluation of Violence Against Women: Case Analysis from a Tertiary Women's Health Facility in Upper Egypt

Background: Violence against women (VAW) remains a critical public health and human rights issue in Egypt, with intimate partner violence and sexual assault being the most common forms. Despite national policies and specialized services, data on hospital-based responses to VAW in Upper Egypt remain limited. Methods: This cross-sectional study examined all female victims (n = 65) presenting to the Safe Woman Unit at Assiut University Women’s Health Hospital between March 2022 and February 2023. Demographic data, violence characteristics, clinical findings, complications, and outcomes were recorded. Comparative analysis between physical and sexual violence groups was performed, and binary logistic regression identified predictors of outcomes. Results: Most victims were aged 20–40 years, with more than one-quarter younger than 20. Nearly all were unemployed, and most were married. The majority of assaults were committed by a single perpetrator, most commonly the husband. Sexual violence predominated over physical violence. Operative management was required in 58.5% of cases, while complications included vaginal bleeding, abortion, need for blood transfusion, pelvic complications, and psychological trauma. Sexual assault victims were younger (23.3 vs. 27.4 years), more often single or divorced, and more likely to present late (> 72 h, 30.2% vs. 4.5%). Logistic regression revealed that age < 20 years, rural residence, single-perpetrator assault, and late presentation were independent predictors of adverse outcomes. Access to psychological counselling was protective. Conclusion: VAW in Upper Egypt predominantly affects young, unemployed, and married women, with sexual violence more common than physical violence. Adolescents and rural women are especially vulnerable, while delayed reporting exacerbates risk. The findings underscore the need for comprehensive, survivor-cantered services, integrated psychosocial support, and preventive strategies promoting education, empowerment, and timely reporting.