Sexual violence within marriage (SVWM) is a major public health and human right issue and yet remains a much neglected research area, especially in Nepal. An exploratory study using free listing, in-depth case histories and causal flow analysis was conducted among two major ethnic groups in Nepal. Descriptive data collected from free listing indicate that about half of the married women aged 15 to 24 years reported ever experiencing SVWM. Data revealed that the underlying reasons for SVWM are complex and complicated due to the multiple forms and contexts in which it occurs. For many couples, multiple factors alongside, and within, their socioeconomic and cultural contexts contribute to the risk of experiencing SVWM. Major factors escalating the risk to SVWM include gender norms, economic dependence of women, poverty, alcohol consumption of husband, lack of knowledge, social stigma, and lack of supportive familial and social environment. Raising awareness about sexual violence is required for its prevention and for managing the consequences. Further research is required to identify the determinants, the effects of SVWM on sexual and reproductive health outcomes and to help programs develop the best strategies for dealing with SVWM among young couples. (Contains 3 tables.)