Background: Diagnostic delay is an important barrier to timely management of gynaecological malignancies and may result from patient-, provider-, and health-system-related factors. Identifying referral patterns and stages of delay may help improve timely diagnosis. Objective: To assess the patterns of referral and diagnostic delay among women with newly diagnosed gynaecological malignancies attending a tertiary care hospital. Methods: This prospective observational study was conducted from January 2026 to June 2026 among 150 women with newly diagnosed, histopathologically confirmed gynaecological malignancies attending the Department of Gynaecological Oncology, National Institute of Cancer Research & Hospital, Dhaka. Sociodemographic characteristics, presenting symptoms, initial healthcare contact, referral source, number of healthcare visits, diagnostic investigations, and reasons for delay were recorded. Diagnostic intervals were assessed from symptom onset to first healthcare contact, referral, specialist consultation, and histopathological confirmation. Results: The mean age of participants was 48.5 ± 13.8 years. Cervical cancer was the most common malignancy (52.0%), followed by ovarian (21.3%) and endometrial cancer (16.0%). Private clinics/hospitals were the most common initial healthcare facility (32.0%), while government hospitals were the leading referral source (31.3%). The mean overall diagnostic interval was 95.6 ± 48.3 days, and 39.3% of participants had an interval exceeding 90 days. Lack of awareness (36.0%), financial constraints (31.3%), delayed referral (27.3%), and repeated consultations (25.3%) were the major reported contributors to delay. Conclusion: A considerable diagnostic interval was observed, with delays occurring at multiple stages of the healthcare pathway. Strengthening awareness, referral systems, and timely diagnostic services may facilitate earlier diagnosis.