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Attention Deficit Hyperactivity Disorder (ADHD) affects children’s academic performance, necessitating an understanding of achievement variations across subgroups for targeted interventions. This study assessed the academic achievement of 500 students with ADHD in Prayagraj district, India, comparing results by gender, locale (urban vs. rural), and institution type (government vs. private). Using a quantitative design, academic achievement was measured by final exam marks and analysed with descriptive statistics and t-tests. The mean score was 58.42% (SD = 12.63), with 32.4% scoring below 50%. Female students outperformed males (t = -4.56, p < 0.001), and private school students excelled over government school students (t = -6.21, p < 0.001). No significant difference was found between urban and rural locales (t = 1.35, p = 0.178). The study highlights the vulnerability of ADHD students, especially boys and those in government schools, recommending interventions to address these disparities.