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This study investigated the consequences of open defecation practices inSoutheast Nigeria utilizing a mixed-methods research design. Quantitative data werecollected through questionnaires distributed among a broad adult population, whilequalitative insights were obtained via in-depth interviews with community stakeholders. Thisstudy focused on six communities in the states of Ebonyi, Enugu, and Imo, which wereidentified as highly affected by open defecation according to the 2019 UNICEF report andthe 2011 Multi-Indicator Cluster Survey. A sample size of 1,049 was determined using TaroYamane’s formula, and a multistage cluster sampling technique was employed. Datacollection involved structured questionnaires addressing sociodemographic factors andspecific research objectives and IDIs providing detailed qualitative insights. Quantitative datawere analysed using SPSS version 20, descriptive statistics and inferential statistics wereapplied, while qualitative data were thematically analysed. The findings revealed that opendefecation significantly contributes to waterborne diseases, environmental degradation, socialstigmatization, and economic burdens. It also undermines educational outcomes. The studyrecommended government-led public health campaigns, investment in sanitationinfrastructure, and community engagement programs such as Community-Led TotalSanitation (CLTS) to promote behavioural change and improve sanitation practices.