<p>While the physical effects of climate change and the mental health effects of climate-related disasters have been widely documented, climate change anxiety has been less studied, especially outside of a Western context. Younger generations will be particularly affected by climate change during their lifetimes. Predictors and psychological effects of climate change anxiety have been less studied in younger populations. The LMIC university setting is uniquely positioned to enact social, cultural, and political change regarding environmental issues. Additionally, anxiety and depression are higher among university students, and worrying about climate change may exacerbate existing mental health conditions, especially in regions thought to be highly susceptible to climate change, such as sub-Saharan Africa. South Africa is particularly vulnerable to the adverse effects of climate change, with Cape Town having experienced a severe water shortage, which is projected to recur. Our study assessed the relationship between several psychological, experiential, and behavioral factors and climate change anxiety among university students studying in Western Cape, South Africa (<i>N</i> = 343). Climate change anxiety was assessed using the Climate Change Anxiety Scale (Clayton and Karazsia, Journal of Environmental Psychology 69:101434, 2020). Prevalence of climate change anxiety was higher among students with higher general anxiety, higher depression, higher environmental concern, higher nature-relatedness, higher climate-related information-seeking behavior and exposure, more pro-environmental behaviors, more climate impacts experienced, and more visits to green space. Correlations with climate change anxiety were highest with climate-related information-seeking behavior. Hierarchal regression indicated that 58.6% of climate change anxiety was accounted for by general anxiety, climate concern, nature relatedness, environmental values, pro-environmental behaviors, and climate-related information-seeking behavior. When all factors were considered, climate impacts, information exposure, pro-environmental behavior, visits to green space, and depression were no longer significant predictors. Further research is needed to assess the prevalence and severity of climate change anxiety and predictors among university students in LMIC countries to inform the development of prevention and intervention strategies, institutional policies, and future research programs in university settings. Coping, resilience, and cultural implications should be examined from an environmental justice perspective.</p>