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Background: The use of restraint in psychiatric inpatient settings is a contentious issue, balancing patient safety with ethical concerns. Despite India's Mental Healthcare Act of 2017, which prohibits seclusion and mandates stringent restraint regulations, restraint remains a critical intervention in managing acute behavioral crises. This study investigates the prevalence, patterns, and determinants of restraint use in a tertiary care psychiatric facility in Northern India. Materials and Methods: This hospital-based, observational, prospective study was conducted over 6 months in a 32-bedded psychiatry ward. Data were collected from ward registers, treatment charts, and patient records, documenting restraint events. Sociodemographic and clinical factors were analyzed using descriptive statistics, comparisons, and logistic regression. Results: Among 128 admissions (5,518 inpatient days), 35.1% of patients experienced restraint, yielding a restraint patient rate of 8.15 per 1000 inpatient days and an event rate of 26.1 per 1000 inpatient days. Chemical restraint was predominant (74.3% of events), followed by combined (22.9%) and physical restraint (2.8%). Restraint occurred primarily in young adults with mood and psychotic disorders, with no significant association between restraint use and sociodemographic or clinical factors. Most restraints were applied within the 1st week of admission. Conclusions: Restraint, primarily chemical, remains common in managing acute agitation and violence, especially early in hospitalization. The findings underscore the importance of balancing clinical needs with patient rights while striving for noncoercive, patient-centered psychiatric care. The findings also highlight the need for standardized reporting and continued training to minimize restraint use and promote ethical healthcare delivery. [ABSTRACT FROM AUTHOR]