This study examines the prevalence and consequences of gender-based violence (GBV), particularly sexual violence, during the two-year armed conflict in Northern Ethiopia. The conflict, which began in November 2020 and ended in November 2022, resulted in widespread displacement, trauma, and sexual violence against women and girls. A total of 1,177 GBV survivors reported their experiences to healthcare facilities, with sexual violence being the most prevalent form. Survivors described various forms of GBV, including gang rape, physical assault, psychological abuse, and deprivation of basic needs. Many survivors faced stigma, discrimination, and social isolation, which further exacerbated their trauma. The study used a mixed-methods approach, combining qualitative interviews with quantitative data from healthcare records. Qualitative findings revealed that perpetrators often targeted vulnerable groups, including pregnant women, children, and the elderly, and used violence as a means of political revenge and control. Survivors reported long-term psychological and physical consequences, including post-traumatic stress, depression, and suicidal thoughts. The study also highlighted the lack of adequate support and mental health services for GBV survivors, emphasizing the need for comprehensive interventions to address the multifaceted impact of GBV in conflict-affected areas. The findings underscore the urgent need for targeted policies and programs to support GBV survivors and prevent future violence in conflict zones.This study examines the prevalence and consequences of gender-based violence (GBV), particularly sexual violence, during the two-year armed conflict in Northern Ethiopia. The conflict, which began in November 2020 and ended in November 2022, resulted in widespread displacement, trauma, and sexual violence against women and girls. A total of 1,177 GBV survivors reported their experiences to healthcare facilities, with sexual violence being the most prevalent form. Survivors described various forms of GBV, including gang rape, physical assault, psychological abuse, and deprivation of basic needs. Many survivors faced stigma, discrimination, and social isolation, which further exacerbated their trauma. The study used a mixed-methods approach, combining qualitative interviews with quantitative data from healthcare records. Qualitative findings revealed that perpetrators often targeted vulnerable groups, including pregnant women, children, and the elderly, and used violence as a means of political revenge and control. Survivors reported long-term psychological and physical consequences, including post-traumatic stress, depression, and suicidal thoughts. The study also highlighted the lack of adequate support and mental health services for GBV survivors, emphasizing the need for comprehensive interventions to address the multifaceted impact of GBV in conflict-affected areas. The findings underscore the urgent need for targeted policies and programs to support GBV survivors and prevent future violence in conflict zones.