Background: Cervical carcinoma is a major cause of morbidity and mortality among women in developing countries, where screening facilities are often limited. This study aimed to evaluate the sociodemographic profile, reproductive characteristics, clinical features, risk factors, and histopathological patterns in VIA-positive women. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Rajshahi Medical College Hospital, Rajshahi, Bangladesh, from July 2007 to December 2007. This study included 100 VIA positive women attending the OPD of Obstetrics and Gynaecology during the study period. Results: Most participants were aged 30–39 years (49%), resided in urban areas (64%), and were predominantly housewives (77%). Nearly half (48%) had parity between 3–4, and three-fourths (75.3%) experienced their first delivery before 20 years. The mean age of menarche was 12–13 years. Excessive vaginal discharge (54%), dyspareunia (44%), and backache (30%) were the most frequent complaints, while 35% were asymptomatic. Major risk factors included early age at first coitus (78%), early childbirth (75.3%), and high parity (61%). Histopathological findings revealed normal results in 25% and inflammation in 23%, while 29% had CIN I, 12% CIN II, 6% CIN III, and 5% invasive carcinoma. Overall, 52% had pre-invasive or invasive lesions. Conclusion: The findings highlight early sexual debut, early childbirth, and high parity as key risk factors for cervical pathology in VIA-positive women. Strengthening cervical cancer screening and awareness programs is essential for early detection and prevention.