Abstract: Understanding regional demographic patterns is essential for effective development planning, especially in regions characterized by socio-economic diversity, cultural heterogeneity, and uneven healthcare access. The Bilaspur Division of Chhattisgarh—comprising Bilaspur, Korba, Raigarh, Janjgir-Champa, Mungeli, and Gaurela-Pendra-Marwahi (GPM)—presents significant spatial disparities in fertility and mortality outcomes. This study provides a comprehensive analysis of fertility indicators such as Total Fertility Rate (TFR), Crude Birth Rate (CBR), General Fertility Rate (GFR), and Adolescent Fertility Rate (AFR), alongside mortality parameters including Infant Mortality Rate (IMR), Under-5 Mortality Rate (U5MR), Crude Death Rate (CDR), and Maternal Mortality Rate (MMR). Using secondary data and comparative district-wise evaluation, the study identifies a clear demographic gradient ranging from low fertility and low mortality in Bilaspur to high fertility and high mortality in GPM and Mungeli. These differences are deeply shaped by socio-economic conditions, women’s literacy levels, healthcare infrastructure, cultural norms, and geographic accessibility. The study highlights the urgent need for district-specific health interventions, educational investments, and strengthened maternal-child health programs. The findings contribute to regional population studies and offer insights for designing targeted policies to reduce fertility and mortality inequalities in the Bilaspur Division.