<p><strong>Introduction.</strong> Oral contraceptive pills (OCP) are the most widely used form of reversible contraception globally, although their prevalence of use varies across regions. In Bosnia and Herzegovina, particularly among young women, there remains a significant gap in knowledge regarding sexual and reproductive health, including contraception. Low level of knowledge, limited financial resources, inadequate access to gynecologists, and factors related to religion or nationality <br />have been identified as predictors of OCP non-use. This study focused on a student population to assess knowledge, attitudes, and practices regarding OCP use. We further examined associations between OCP use and demographic, medical, and knowledge-related factors. The investigation aimed to identify determinants promoting positive attitudes and practices toward OCP.<br /><strong>Methods.</strong> A cross-sectional online survey was conducted in 2024 among 162 female students at the University of East Sarajevo. Data were collected using a specially designed questionnaire assessing demographic characteristics, gynecological and medical profiles, as well as knowledge, attitudes, and practices related to OCP.<br /><strong>Results.</strong> Among 162 surveyed students, only 13 (8%) reported current OCP use, while the additional 21 students (14.2%) reported previous use. More than one-third of participants stated that they would never use OCP. Knowledge and positive attitudes emerged as the most significant predictors of OCP use, in contrast to demographic and most medical factors.<br /><strong>Conclusion.</strong> The prevalence of OCP use among students at the University of East Sarajevo is lower than in Western countries. Fear of side effects and insufficient knowledge of the benefits of OCP represent the main reasons for non-use. Although students of medical sciences demonstrated greater knowledge toward OCP, their knowledge was not sufficient to significantly increase OCP use within this population.</p>