Background Spousal violence is a critical public health issue in India, with profound physical, psychological, and sexual consequences, particularly among married women of reproductive age in rural areas, where the risk is alarmingly high. The aim of the study is to assess various forms of spousal violence, its associated factors, and the pathways leading to different forms of abuse among women of reproductive age residing in the selected rural area of Chengalpattu District, Tamil Nadu. Methodology A community-based cross-sectional study was conducted on 250 married women of reproductive age. The participants were selected using systematic random sampling from a prepared line list. Data were collected from a sample of 250 women through face-to-face interviews using the Indian Family Violence and Control Scale (IFVCS), and multivariate logistic regression analysis and path analysis were performed using SPSS v25 (IBM Corp., Armonk, NY, US). Results Multivariate analysis identified regular alcohol consumption of husbands and spousal violence had the highest odds for all three forms of spousal violence: psychological violence (odds ratio (OR) = 5.15, 95% CI: 2.62-10.11), physical violence (OR = 6.6, 95% CI: 3.29-13.23), and sexual violence (OR = 2.89, 95% CI: 1.09-7.69). Other factors, such as nuclear families and lower socioeconomic status, were found to be significantly more vulnerable. Path analysis indicated that psychological violence often precedes physical and sexual violence, with alcohol consumption acting as a key trigger. Conclusion Women often face multiple interrelated forms of violence, with significant determinants including husbands’ alcohol use, nuclear families, and lower socioeconomic status. Therefore, a multifaceted strategy is needed to prevent this threat.
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