Background: Infertility remains a major reproductive health challenge with profound psychosocial and cultural consequences, particularly in sub-Saharan Africa, where family expectations and societal norms strongly influence women’s experiences. Understanding family dynamics, social support, and attitudes toward child adoption is essential for improving infertility care. Aim: To assess family peculiarities, social support, and acceptance of child adoption among women with infertility attending a tertiary hospital in Sokoto, northwestern Nigeria. Materials and Methods: A hospital-based cross-sectional study was conducted among 156 women with infertility selected using systematic sampling. Data were collected using a structured interviewer-administered questionnaire and analyzed with IBM SPSS version 20. Descriptive statistics were used to summarize the findings. Results: The respondents had a mean age of 28.3 ± 6.4 years, and over half (51.9%) were in monogamous marriages. Among women in polygamous unions, fourth wives constituted the largest proportion (51.6%). Secondary infertility was more common than primary infertility (60.7% versus 39.3%). Most respondents reported that their husbands financed infertility treatment (81.1%), while relatives were the predominant source of social support (91.0%). Despite strong family support, the majority of respondents (71.3%) were unwilling to adopt a child, while only 25.4% expressed willingness to do so. Conclusion: Acceptance of child adoption was low among women with infertility despite substantial familial and spousal support. Integrating culturally sensitive counselling on child adoption into infertility care, strengthening family-centred psychosocial support, and implementing community-based awareness programmes may improve acceptance of child adoption and enhance the overall well-being of women experiencing infertility..