ABSTRACT Background: Female genital mutilation (FGM) is widely acknowledged globally as a violation of the fundamental human rights of girls and women. FGM is still widely practiced in Nigeria but at diminishing rates. Primary care physicians must educate and campaign to end this hazardous practice in Nigeria, especially in high-incidence areas. This study fills the knowledge gap by identifying FGM determinants to help policymakers reduce it. Method: The study employed a retrospective cross-sectional design using data from the United Nations International Children’s Emergency Fund for 2011, 2016–2017, and 2021. The sampling involved multistage cluster sampling. Data analysis utilized IBM-SPSS, presenting FGM prevalence across years and exploring associations with various factors. Results: This study analyzed 63,365 Nigerian women across a decade (2011, 2016–2017, and 2021). FGM awareness fluctuated (35.1% in 2016–2017, 33.0% in 2011, and 31.9% in 2021), while FGM prevalence increased from 46.6% (2011) to 69.5% (2021). Education correlated with lower FGM prevalence. Geographic disparities were observed, with the Southwest having the highest (70.1%) and the Northeast having the lowest (34.5%) prevalence. Religion influenced FGM rates, with Christians (54.2%) and those with other/no religion (58.0%) showing higher rates than Muslims (52.6%). Urban women had a slightly lower prevalence (52.6%) than rural women (54.2%), and wealth quintiles displayed variations. Variability was also evident among states, ranging from 2.0% to 86.3%. Daughters’ circumcision was influenced by maternal circumcision status, education, region, religion, and wealth quintile. Common FGM procedures involved removing genital flesh (63.7%) and nicking without removal (55.1%), often performed by nurses/midwives (63.7%). Conclusion: The study emphasized the urgent need for continuous awareness campaigns and education to combat FGM among Nigerian women. Education emerged as a critical factor in reducing FGM, highlighting the importance of investing in girls’ education.