The present study examines consumer perception and preferences toward organic fruits and vegetables in selected districts of the Rayalaseema region of Andhra Pradesh, focusing on their influence on consumer satisfaction. Using a quantitative research design, data were collected from 169 respondents through a structured questionnaire on a five-point Likert scale. The findings reveal that middle-aged adults, particularly females, dominate the consumption of organic produce, with most respondents being well-educated and professionally employed. Analysis of consumer perception factors indicates that Price–Value has the strongest impact on satisfaction, followed by Quality, Health & Safety, Availability & Access, and Certification & Trust, suggesting that consumers prioritize affordability, product quality, and health benefits when evaluating organic products. Furthermore, consumer perception significantly enhances satisfaction both directly and indirectly through consumer preference as a mediator, highlighting that preferences amplify the effect of perceptions on satisfaction. The study underscores the importance of improving consumer perception and fostering preferences to boost satisfaction, adoption, and loyalty toward organic fruits and vegetables. These findings provide actionable insights for marketers, local producers, and policymakers to design strategies that align with consumer expectations and promote the growth of the organic food market in Rayalaseema.