摘要:BACKGROUND: India today is home for the largest youth population in the world. Youth is a formative phase transitioning from childhood to adulthood. Relationship is fundamental for a healthy and satisfactory life. Relationships assume importance and maturity during adolescence and youth. Relationships and mental health have a bidirectional effect. The effect of relationships on mental health is stronger than vice versa. MATERIALS AND METHODS: Two-year case record analysis of 8595 beneficiaries aged 15–35 years attending youth guidance centers (Yuva Spandana Kendras) in Karnataka, India, was undertaken to understand factors affecting relationship issues among them. Multivariate logistic regression was performed with any beneficiary having a relationship issue as outcome. RESULTS: Being a student (adjusted odds ratio [AOR] = 1.49; 95% confidence interval [CI] = 1.18–1.89), occupation (AORbusiness/salaried = 3.04; 95% CI = 2.10–4.40 and AORothers = 1.72; 95% CI = 1.22–2.44), marital status (AORmarried = 1.42; 95% CI = 1.06–1.90 and AORothers = 3.44; 95% CI = 1.45–8.15), having health and lifestyle issues (AOR = 3.61; 95% CI = 3.05–4.27), personality issues (AOR = 2.88; 95% CI = 2.43–3.41), safety issues (AOR = 6.28; 95% CI = 5.01–7.87), gender, sex, and sexuality issues (AOR = 3.10; 95% CI = 1.93–4.98), suicidality (AOR = 1.82; 95% CI = 1.17–2.85), alcohol use (AOR = 5.43; 95% CI = 3.92–7.41), and different emotions experienced (AOR ranging from 0.37 to 3.50), had significant association with relationship issues. CONCLUSION: Investing in health promotion interventions focusing on these precursors of relationship issues among youth seems strategic. Our findings have implications for other states in India and other low-middle-income countries like India.