Background: Culture of elopement with romantic partners in adolescent girls with subsequent child sexual abuse (CSA) is a significant public health concern in low- and middle-income settings, often leading to profound psychosocial distress and a high risk of revictimization. This study investigated the relationship between perceived social support, psychosocial difficulties, and re-elopement among adolescent survivors in Sri Lanka. Methods: A cross-sectional analytical study was conducted at "Lama Piyasa," Child Protection Unit, Teaching Hospital Ragama. Data were collected from 68 adolescent girls (ages 14–17) using the Strengths and Difficulties Questionnaire (SDQ) and the Multidimensional Scale of Perceived Social Support (MSPSS). Results: The mean age at initial elopement was 14 (+/- 0.76) years. Family dysfunction, including domestic violence (60.3%) and paternal alcohol use (86.4%), was a major attribute for elopement. Notably , 91.2% of adolescents were unaware of the legal age of consent. The reelopementrate was 17 .6%. It is also observed that the school dropout rate among these adolescents is 44.1%. Significant negative correlations were found between family support and total psychological difficulties (r = -.451, p < .001). Predictors of re-elopement included low family support (p < .001), high difficulty scores (p = .006), and household substance use (p < .001). Conclusion: Household dysfunction, legal illiteracy , and low family support increase vulnerability to re-elopement among adolescent CSA survivors. Strong family support acts as a protective factor, mitigating the risk of revictimization. Structured multidisciplinary interventions, including psychosocial support, family engagement, legal education, and school re-entry programmes, should be implemented alongside community-based initiatives.