OBJECTIVE: -Hypertension is increasingly recognized among young adults, yet data on its prevalence and associated risk factors in medical students from Pakistan remain limited. This study aimed to determine the prevalence of prehypertension and hypertension among undergraduate medical students in Lahore and to assess their awareness of risk factors associated with hypertension. Methods A cross-sectional study was conducted at A Private Medical college Hospital, Lahore, during the academic year 2024–2025. A total of 210 undergraduate students from medicine, dentistry, nursing, and allied health sciences participated (response rate: 70%). Data were collected using a pretested, structured, self-administered questionnaire assessing sociodemographic variables, lifestyle factors, and knowledge of hypertension risk factors. Blood pressure was measured twice using a mercury sphygmomanometer. Statistical analysis was performed using SPSS-17, including chi-square tests and multivariable log-binomial regression to identify predictors of prehypertension and hypertension. Results Conclusion A considerable proportion of students exhibited prehypertension or hypertension. Awareness was high for several modifiable risk factors, including psychosocial stress, high cholesterol, obesity, smoking, and high-calorie diets. However, knowledge gaps were evident regarding physical inactivity, oral contraceptive use, and non-modifiable factors like, family history and aging. Male emerged as a strong independent predictor of elevated blood pressure. Obesity and alcohol consumption were also significantly associated with prehypertension. Despite reasonable awareness of common lifestyle-related risk factors, significant knowledge deficiencies and a notable prevalence of hypertension exist among undergraduate medical students. Early screening, health education, and preventive interventions are urgently needed to reduce the future burden of hypertension in this high-risk young adult population.