In Pakistan, it is estimated that the prevalence of tobacco smoking is 36% for males and 9% for females. Among young adults especially the university students in Pakistan, the prevalence of smoking is 15% with the majority being male smokers. Approximately 1,200 children start smoking every day Smoking is one of the leading causes of preventable death. According to World Health Organization (WHO) tobacco use is currently responsible for the death of one in ten adults worldwide (about 5 million deaths each year)4.The main objective of this study is to estimate the prevalence and probable risk factor of tobacco and shisha smoking among university studentsIt was a cross sectional study conducted at Sialkot Medical College, Sialkot among male and female university students. For data collection a self-administered questionnaire was used as a tool. The sampling technique used in this study was convenience sampling a type of non-probability sampling. In this technique the students were selected for questioning on the basis of their availability and self- interest after taking consent. Each student was clearly informed about this study after that they actively participated.From this study results we have concluded that Out of 95 medical students of Sialkot medical college, Sialkot, (15.78%) medical students were smokers and in which 12 male medical students (18.18%) out of 66 male medical students and 3 female medical students (10.34%) out of 29 female medical students were smokers. In this cross sectional study out of 100 medical students of Sialkot medical college, Sialkot from 2nd year, 3rd year and 4th year MBBS classes 95 students participated. The overall prevalence of smoking was 15 (15.78%). Among 100 participants 66 (69.47%) were males and 29 (30.52%) were females. Among these males and female medical students 15 medical students were smokers. The ages of participants range from 19-25 years. Age of 21 years is more frequent in frequency distribution table number-The overall knowledge among smoker medical students about smoking and its hazards was about 60%. The good attitude of quitting smoking was present in about 60% of the smoking medical students. About 40% smoking medical students started smoking because of peer pressure and stress and 20% smoke because of curiosity.