Aim: The aim of this study was to evaluate the clinical and etiological profile of hypothyroid patients, including demographic characteristics, common clinical symptoms, biochemical parameters, and factors predicting elevated TSH levels. Material and Methods: This was a prospective, observational, cross-sectional study conducted in the Department of General Medicine. A total of 200 hypothyroid patients, aged 18 years and above, attending outpatient and inpatient services were included based on clinical symptoms and biochemical confirmation. Data were collected using a structured proforma, which included demographic details, clinical presentations, vital parameters, and biochemical evaluation, including serum TSH, Free T3, Free T4, and anti-TPO antibody levels. Etiological classification was performed, and comparisons of biochemical parameters across age groups were analyzed using the ANOVA test. Results: The majority of patients (40%) were in the 31–50 years age group, and females constituted 70% of the study population. Fatigue (85%), weight gain (75%), and cold intolerance (67.5%) were the most common symptoms. Biochemical analysis revealed a mean TSH level of 15.8 ± 5.6 mIU/L, mean Free T4 of 0.6 ± 0.3 ng/dL, and elevated anti-TPO antibodies (152.5 ± 60.4 IU/mL). Autoimmune thyroiditis was the most common etiology (60%), followed by iodine deficiency (22.5%). ANOVA analysis showed significant age-wise differences in TSH, Free T4, and BMI (p < 0.05). Regression analysis identified anti-TPO antibodies, BMI, and age as significant predictors of TSH levels (R² = 0.412, p < 0.05). Conclusion: The study demonstrates that hypothyroidism predominantly affects middle-aged females, with autoimmune thyroiditis being the primary cause. Fatigue and weight gain were the most common symptoms, and age, BMI, and anti-TPO antibody levels were significant predictors of elevated TSH. Early screening and comprehensive management strategies are essential for improving patient outcomes.