Background: India accounts for approximately a quarter of global cervical cancer deaths, yet screening coverage remains among the lowest worldwide. Understanding the knowledge deficits and health beliefs that underlie non-participation is essential for designing effective demand-generation strategies. This study assessed knowledge of cervical cancer and Visual Inspection with Acetic Acid (VIA) screening, Health Belief Model (HBM) profiles, and determinants of screening uptake among women aged 30–49 years. Methods: A community-based cross-sectional study was conducted among 300 women aged 30–49 years residing in the rural and urban health training centre catchment areas of a medical college hospital in Indore, Madhya Pradesh. Women who had not been screened in the preceding three years and who had no history of cervical cancer or hysterectomy were enrolled. Data were collected through face-to-face interviews using a structured socio-demographic and reproductive history schedule, a 25-item knowledge questionnaire, and a Hindi-validated adaptation of Champion’s Health Belief Model Scale (30 items across six constructs, 5-point Likert). Determinants of subsequent VIA screening uptake, verified through screening registers, were examined using logistic regression. Results: The mean age of participants was 39.7 ± 5.4 years; 60.3% were homemakers, 31.3% had no formal or only primary education, and 35.0% reported a monthly family income below ₹10,000. Knowledge of cervical cancer and VIA screening was low, with a mean score of 8.7 ± 3.2 out of 25. The HBM profile was characterized by high perceived barriers (3.45 ± 0.65), moderate perceived severity (3.35 ± 0.75), and low self-efficacy (2.85 ± 0.65) and cues to action (2.65 ± 0.75). On multivariate analysis, higher baseline knowledge (adjusted OR 1.11 per point, 95% CI 1.02–1.21, p = 0.02) and higher self-efficacy (adjusted OR 1.48 per unit, 95% CI 1.02–2.15, p = 0.04) independently predicted screening uptake, while age, income, and parity did not; education at secondary level or above showed a borderline association (adjusted OR 1.74, 95% CI 0.97–3.12, p = 0.06). Conclusion: Women in this population begin from a position of substantial knowledge deficit, high perceived barriers, and low self-efficacy. Because knowledge and self-efficacy independently predicted screening uptake, interventions that combine education with explicit barrier reduction and confidence building are likely to be more effective than awareness campaigns alone.