Background: Fertility dynamics within the unique demographic of Kashmiri females under the age of 40 remain a subject of intrigue. This study endeavors to shed light on these complexities by delving into the intricate interplay of Anti-Mullerian Hormone (AMH) levels, a pivotal biomarker of ovarian reserve, among fertile and infertile individuals. Methods: In a meticulously conducted prospective observational case-control study, we sought to elucidate potential disparities in AMH levels between these contrasting groups. Two hundred participants undergoing infertility assessments were compared to an equal number of controls with documented fertility. AMH levels were quantified through rigorous hormonal assays, complemented by the compilation of relevant clinical data. Results:Our findings unveiled notable distinctions in AMH levels between fertile and infertile Kashmiri females under 40 years of age. Significant differences in AMH levels were observed between age groups. In the 25-29 years category, cases had lower AMH levels (1.57 ng/ml) compared to controls (3.12 ng/ml) (p < 0.001*). In the 30-34 years group, cases had lower AMH levels (0.82 ng/ml) than controls (2.61 ng/ml) (p < 0.001*). Among those aged 35-39 years, cases had reduced AMH levels (0.54 ng/ml) compared to controls (2.01 ng/ml) (p < 0.001*). The optimal cutoff value for AMH in predicting infertility was less than 1, serving as a threshold for identifying individuals at risk of infertility. Sensitivity, indicating AMH's ability to correctly identify individuals with infertility, was calculated at 80.5% (95% CI: 74.5% - 85.3%). Overall, the diagnostic accuracy of AMH in predicting infertility was determined to be 79.3% (95% CI: 75.0% - 82.9%), highlighting its effectiveness in categorizing individuals as infertile or not with an accuracy of 79.3%.Conclusion: AMH demonstrates its potential as a reliable tool for categorizing individuals as either infertile or not, offering valuable insights into reproductive health and fertility potential. These insights contribute to our broader comprehension of the complex interplay of factors shaping fertility in the Kashmiri context and may pave the way for more tailored approaches to address reproductive challenges within this unique population.