Purpose <p>This study investigated the direct and indirect associations between attachment insecurities and four forms of intimate partner violence (IPV)—physical, psychological, sexual, and coercive control—through psychological distress and substance use.</p> Methods <p>A sample of 1034 men entering an IPV-specialized treatment answered validated questionnaires assessing attachment, psychological distress, substance use, and perpetrated intimate partner violence behaviors (physical, psychological, sexual, coercive control).</p> Results <p>Higher attachment-related anxiety was directly related to increased reports of psychological and sexual IPV and coercive control, whereas attachment-related avoidance was related to higher psychological IPV. Attachment-related anxiety was indirectly related to higher psychological IPV through psychological distress, problematic substance use, and cannabis use. Attachment-related anxiety was indirectly related to higher coercive control and sexual IPV through psychological distress, and to coercive control through higher problematic substance use and psychological distress. Attachment-related avoidance was related to the perpetration of psychological IPV, coercive control, and sexual IPV through higher psychological distress and problematic substance use.</p> Conclusions <p>Findings suggest that clinicians should consider attachment and harm reduction strategies for substance use to mitigate IPV perpetration.</p>