Even though frequency of depression is documented globally, the spectrum of depression and its inciting factors in Pakistan are unique to the local cultural and social beliefs. Objective: To compare the status of depression and its provoking socio-cultural factors among urban and rural females attending selected hospitals of Peshawar. Materials & Methods: A cross-sectional comparative study was conducted from March to May 2017 on 93 female patients attending two selected urban and rural

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... hospitals of Peshawar. Data were collected on Beck Depression Inventory through convenience sampling, and were analyzed for descriptive statistics by SPSS version 20. Comparisons were done by the Chi Square test and the Student's T test keeping p≤0.05 as significant. Results: Out of 93 female patients, a final 89 females (53 urban and 36 rural) were included due to incomplete data entries. More urban females were in the normal, mild or borderline clinically depressed categories (38/53, 71.7%), compared to rural females (15/36, 41.7%), more of whom were in moderate, severe and extremely depressed categories (21/36, 58.3%); the difference was significant (p=0.025). Among the many factors leading to depression, there were significant differences in poor socio-economic status (p=0.011), illiteracy (p=0.003) and hostile in-laws (p=0.016), all of which were mainly due to females of rural area rather than urban females. Conclusion: Rural females suffered significantly greater depression compared to their urban counterparts related to poor socio-economic status, illiteracy, and hostile in-laws. Keywords: Depression; Anxiety; Stress; Female; Marriage; Domestic Violence.