Background <p>Violence against women (VAW) remains a critical public health and human rights issue in Egypt, with intimate partner violence (IPV) 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. This prospective hospital-based observational study examined all female survivors (<i>n</i> = 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 analyses were performed between physical and sexual violence cases to describe patterns of presentation, clinical findings, and management needs.</p> Results <p>Most victims were aged 20–40 years ranging from 12 years to 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, pregnancy loss, 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 (&gt; 72&#xa0;h, 30.2% vs. 4.5%). Adolescents, rural residents, and survivors of sexual violence were more likely to present late (&gt; 72&#xa0;h), highlighting barriers to timely disclosure and access to care.</p> Conclusion <p>Adolescents and rural women appear particularly vulnerable, and delayed reporting remains a major challenge. The findings underscore the need for comprehensive, survivor-cantered services, integrated psychosocial support, and preventive strategies promoting education, empowerment, and timely reporting.</p>