Introduction: Maternal mortality and early pregnancy are public health issues closely linked to social, economic, and cultural inequities in Latin America and the Caribbean. In Colombia, these problems reflect the country's structural inequalities, with higher rates among rural, indigenous, and Afro-descendant women. In 2022, the maternal mortality ratio was 44.5 per 100,000 live births, reaching 89.6 in rural areas and 100.7 among indigenous women. Adolescent pregnancy has serious health and socioeconomic implications. In 2021, the fertility rate for children (10-14 years) was 2.5 per 1,000 women, and for adolescents (15-19 years) it was 53.4 per 1,000 women. These phenomena are associated with factors such as poverty, lack of infrastructure, and cultural barriers. Evaluating knowledge, attitudes, and practices (KAP) in sexual and reproductive health is essential to identify knowledge gaps, understand risk behaviors, design appropriate interventions, evaluate programs, and formulate effective public policies. Objective: To describe the sociodemographic characteristics, knowledge, attitudes, and practices regarding sexual and reproductive rights, in relation to pregnancy, care, associated risks, and issues of maternal morbidity and mortality among children, adolescents, and young people aged 10 to 19, and pregnant women over 35 in Cartagena and Risaralda. Methodology: This analytical cross-sectional observational quantitative study was conducted in Cartagena and Risaralda, Colombia, between June and October 2024. The target population included children and adolescents aged 10 to 19, as well as pregnant women under 19 and over 35 years old. Stratified sampling by age and sex was used, with a total sample size of 921 people. The study implemented KAP (Knowledge, Attitudes, and Practices) surveys on sexual and reproductive health, adapted and validated by experts. Variables included sociodemographic aspects, sexual activity, contraceptive methods, gender roles, STIs, pregnancy, and sexual education. Measures were implemented to control for selection and information biases, and descriptive and inferential statistical techniques were used for data analysis. Results: The study conducted in Cartagena and Risaralda, Colombia, evaluated knowledge, attitudes, and practices regarding sexual and reproductive health in different age groups. A total of 923 surveys were applied, including pregnant and non-pregnant individuals. The results show that 52% of respondents have not had sexual intercourse, being more common among those aged 10-14. Condoms are the most used contraceptive method. Economic barriers and parental consent were identified as obstacles to accessing contraceptives. Sexual education is considered important by 83%, but 23% have not received it. Attitudes that normalize unequal relationships and gender violence persist. The study reveals the need to improve sexual education and access to reproductive health services