The provision of care for survivors of sexual violence is a medico-legal emergency. However, due to social issues, healthcare providers face several ethical and legal dilemmas when administering care to such survivors at hospitals. Added to these are the compulsions under mandatory reporting laws, which oblige healthcare providers to abide by the ethical commitments of care and treatment, and make it mandatory for them to report cases of sexual violence to the police, failing which they face legal sanctions. This article draws on global evidence related to mandatory reporting of violence against women and children and the lessons learnt from it. While doing so, it presents the current status of mandatory reporting by healthcare providers in India and the challenges faced by them in operationalising the survivors' autonomy, ensuring confidentiality and overcoming obstacles that may impede treatment and care.