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Sexual autonomy, a measure of gender empowerment, refers to a “woman’s right to refuse (or accept) sex under certain conditions” in a partnership or marriage. Research on predictors of domestic violence suggests that a lack of decision-making ability regarding sex with husband/partner is often associated with domestic violence. This situation can have an impact on several different aspects of public health and social issues that include fertility-related outcomes, large number of births, unwanted pregnancies, short intervals between births, and low contraceptive use, especially in relation to expressed need for fertility control. In this paper we examine the relationship between lower sexual autonomy as reported by men and women and domestic violence in India. More specifically, our goal is to examine if regional differences exist given the size and diversity of the country. Data for this study is drawn from a nationally representative household survey representing over 1,470,000 respondents. Theoretical and policy implications will be discussed.