Background: TikTok has emerged as a major source of health information, including content related to intrauterine devices (IUDs). However, the accuracy, quality, and engagement patterns of IUD-related content on this platform remain insufficiently characterized. This study evaluated the informational quality, thematic focus, misinformation prevalence, and engagement metrics of widely viewed IUD-related TikTok videos. Methods: A descriptive cross-sectional content analysis was conducted of TikTok videos retrieved using 12 IUD-related search terms. Engagement metrics, creator characteristics, and content features were extracted, including educational, testimonial, and advice-seeking videos. Advice-seeking videos were included to capture user-generated concerns and inquiries that may influence engagement with health-related content on social media platforms. Informational reliability and quality were assessed using the Modified DISCERN instrument and the Global Quality Scale (GQS). Differences across groups were examined using t-tests, ANOVA, and chi-square tests. Results: A total of 458 videos were included. Nearly half were testimonial or advice-seeking (47.8%), while 38.9% were educational. Most content was produced by non-healthcare creators (76.4%). Engagement metrics did not differ significantly across video type, source, or creator qualification (all p > 0.05). Frequently discussed topics included adverse effects (36.5%), insertion experiences (31.2%), and device removal or discontinuation (19.9%). Overall informational quality was low, with mean GQS and Modified DISCERN scores of 2.0 and 1.8, respectively. Physician-created content demonstrated significantly higher quality and reliability scores (both p < 0.001). Conclusions: Widely viewed IUD-related TikTok content demonstrates high engagement but generally low informational quality.