Introduction: Whilst there is much research on the economic aspects of international migration, less priority is given to the effects on wives left behind in social and health aspects. This study examines and explores the consequences of international migration on left-behind wives regarding depression, autonomy and health service utilisation. Methods: A sequential mixed-methods study design was employed for the study. A total of 800 households were surveyed (400 migrants and 400 non-migrants) followed by 14 semi-structured interviews. Researcher administered questionnaires were used to collect data for depression, autonomy and health service utilisation and were analysed using multivariate logistic regression to identify significant associations. Semi-structured interviews were then conducted within the surveyed sample and analysed by thematic analysis. Results: This study found that left-behind wives were depressed and 10.57 times greater odds for depression compared to the wives of non-migrants. Multivariate analysis identified that significant contributing factors for depression were caste, education, own named property, household head's education and year of husband's migration. Similarly, left-behind wives experienced greater autonomy compared to the wives of non-migrants. Women's age, own named property, having children, husband's age, household head's gender, age, occupation, and education, family types, number of family members, household income are significantly associated with women's autonomy in the absence of husbands. Moreover, no significant difference was observed between left-behind wives of migrants and wives of non-migrants for health service utilisation for minor illness. However, for any illnesses, left-behind wives were more likely to use private health facilities than the wives of non-migrants. The qualitative findings revealed how separation, added responsibilities, worry about the husband's situation abroad and family type contribute to depression in left-behind wives. Other findings demonstrated how complexities of family structure, traditional culture and belief, having children and level of education influenced women's autonomy. Similarly, availability of health facilities and specialists at one place, poor past experiences at government health centres and accessibility were reported as reasons for using private health facilities by left-behind wives. Conclusions: The increasing trend of male international migration has both positive and negative effects on left-behind wives regarding depression, autonomy and type of health service utilisation. The Government of Nepal should formulate clear planned policies to manage international migration so that its negative consequences can be minimised. No single strategy can be sufficient to cover all aspects of migration and its impacts on left-behind wives. Thus, multidisciplinary approach strategies should be developed to address the multiple effects of migration on left-behind wives.