Background: Thyroid dysfunction is a common endocrine disorder that disproportionately affects women,particularly those of reproductive age. It is associated with various clinical symptoms such as fatigue, weight gain,and menstrual irregularities. Early detection and treatment are crucial, as thyroid disorders can impact reproductivehealth and overall well-being. However, there is limited data on the prevalence and risk factors for thyroid dysfunctionin urban Bangladesh. Objective: This study aimed to assess the prevalence of thyroid dysfunction and explore thesociodemographic, clinical, and laboratory factors associated with thyroid abnormalities among women of reproductiveage in urban Bangladesh. Methods: A cross-sectional study was conducted at Shahid Sheikh Abu Naser SpecializedHospital, Khulna, with 190 female participants aged 18 to 45. Sociodemographic data, clinical symptoms, and thyroidfunction tests (TSH, Free T4, and Free T3) were collected. Descriptive statistics, correlation analyses, and chi-squaretests were employed to analyze the data. Results: The study revealed a high prevalence of thyroid dysfunction, with49.5% of participants being euthyroid and 50.5% exhibiting thyroid abnormalities. The most common dysfunctionwas subclinical hypothyroidism (24.2%), followed by overt hypothyroidism (15.8%). Fatigue (67.4%) and hair loss(57.9%) were the most frequent clinical symptoms. Significant associations were found between thyroid dysfunctionand age (26–35 years), educational status (primary education), and BMI >25 kg/m² (p < 0.05). A positive correlationwas observed between elevated TSH levels and clinical symptoms such as fatigue (r = 0.62, p < 0.05) and weight gain (r= 0.58, p < 0.05). Conclusion: Thyroid dysfunction, especially subclinical hypothyroidism, is highly prevalent amongwomen of reproductive age in urban Bangladesh. Clinical symptoms like fatigue and weight gain correlate stronglywith abnormal thyroid function. Early detection through routine screening and public health interventions focusing onthyroid awareness and iodine supplementation are essential for improving health outcomes in this population.