Gender-based violence (GBV) remains a major challenge in Sub-Saharan Africa, which records the highest prevalence rate globally at 33%, significantly affecting women’s health, well-being, and socio-economic development. According to UN Women, nearly 140 women and girls are killed daily by a partner or family member (UN Women, 2023). This study investigated the prevalence and effects of GBV among women in Kenema City, Eastern Province, Sierra Leone, using a mixed-methods field survey conducted in 2026. The findings revealed a widespread occurrence of GBV, with 95% of respondents reporting exposure to at least one form of violence. Physical violence accounted for 38% of reported cases, while 42% indicated that such incidents occurred occasionally. The majority of participants were young adults aged 15–25 years (57%), with nearly equal representation of males and females. Despite the high prevalence, 74% of victims did not report incidents, suggesting persistent barriers to justice and access to support services. The study further identified multidimensional impacts of GBV, including psychological distress (35%), negative economic consequences (52%), and social isolation (30%), although 45% reported no immediate physical health effects. These findings demonstrate that GBV in Kenema City is widespread yet largely underreported, emphasizing the urgent need for community-based interventions, accessible survivor support systems, and strengthened policy and institutional responses to prevent and address violence.