Background Sexual assault is a significant public health and legal concern with profound physical and psychological consequences for survivors. Understanding injury patterns in such cases is crucial for improving forensic assessments, medical care, and legal proceedings. This study analyzes the demographic characteristics of victims, the nature of injuries sustained, and the forensic evidence collected in reported sexual assault cases. Methods A descriptive observational study was conducted at Pak International Medical College from January 2023 to January 2024. A total of 75 cases were reviewed based on medical and forensic records. Data on demographic details, assault characteristics, injury patterns, and forensic findings were collected and analyzed using statistical methods, including chi-square tests for significance. Results The majority of victims were women aged 18–30 years. Most assaults were penetrative, with a significant proportion involving physical force. Injuries were present in 80% of cases, with bruises, abrasions, and lacerations being the most common. Genital trauma was noted in more than half of the cases. In 70% of cases, forensic evidence was successfully collected, while psychological distress, including PTSD, anxiety, and depression, was observed in many victims. The findings highlight the complexity of sexual assault cases and the need for comprehensive forensic and psychological support. Conclusion This study emphasizes the critical role of forensic examinations in sexual assault investigations. While physical injuries are common, their absence does not rule out sexual violence. Psychological evaluations and forensic evidence remain essential in proving cases and supporting victims. Strengthening forensic protocols, timely medical interventions, and enhanced legal frameworks are necessary to improve justice outcomes and survivor care.