<p>Over the past two decades, research has increasingly highlighted Adverse Childhood Experiences (ACEs) as important factors influencing long-term health outcomes. However, research on the epidemiology and impact of ACEs in low- and middle-income countries, particularly India, remains limited. This study aimed to estimate the prevalence of ACEs and examine their predictors across individual, familial, contextual, and societal levels among young adults in the Delhi-NCR region, India. This cross-sectional study involved 1,843 young adults recruited from two universities in Delhi-NCR. ACEs were assessed using the ACE International Questionnaire, while sociodemographic and lifestyle variables were collected using a pretested interview schedule. The study revealed a high prevalence of ACE exposure, with 72.3% of participants reporting at least one ACE and 17% reporting four or more ACEs. Findings indicated that ACEs were not randomly distributed but patterned across multiple ecological levels of influence. At the individual level, participants identifying as sexual minorities and those with childhood obesity were particularly vulnerable to multiple ACE exposures. At familial and contextual levels, certain parental occupations, attending private schools and early, unsupervised access to mobile phones or the Internet were linked to increased ACE risk. Although societal factors such as caste and religion were not significantly related to ACE exposure, participants from immigrant families showed elevated risk. By adopting a nested ecological model, this study underscores the multilayered determinants of childhood adversity in India. Public health and educational interventions should target high-risk groups across these ecological levels to mitigate the long-term consequences of ACEs.</p>