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Introduction Access to comprehensive sexual health education (SHE) is limited in India’s urban slum communities, where socio-structural barriers restrict awareness of reproductive health. Existing interventions have emphasised menstruation and contraception, with less emphasis on other domains of SHE such as consent, abortion, infertility and gender norms. This study investigated the extent of sexual health knowledge among women in Dharavi, Mumbai, exploring how sociodemographic factors influence understanding across key domains.Methods A cross-sectional survey was administered in Dharavi, Mumbai in 2024 across 4 weeks. A 30-item, multilingual questionnaire, adapted from the Demographic Health Survey Woman’s Questionnaire, was fully completed by 430 participants aged 10 and above. Descriptive statistics were used to assess awareness levels. Chi-square tests and logistic regression models evaluated associations between knowledge, age, education and information sources.Results Most participants reported access to sexual health information (74.7%) and decision-making confidence (65.3%), yet 77.7% still expressed a need for further education. Knowledge and awareness were highest for menstrual health (83.7%) and hygiene (91.4%), but lower for consent (67.0%), contraception (58.6%), abortion (55.3%) and infertility (52.3%). Older participants and those with higher education demonstrated greater knowledge, but key gaps within domains persisted across all groups. Health clinics were the most common information source (36.7%), but participants who accessed media, despite low usage (4.9%), demonstrated the highest levels of knowledge overall.Conclusions Significant disparities remain in SHE knowledge among marginalised urban populations, particularly in domains beyond menstruation and hygiene. These findings underscore the importance of embedding inclusive, evidence-based sexuality education within healthcare services, school curricula and digital platforms. Addressing topic-specific gaps and diversifying trusted information sources are critical to improving reproductive health literacy and autonomy in low-resource urban settings.