Background <p>Self-medication involves taking drugs or herbal products to treat self-diagnosed symptoms or health conditions without consulting a healthcare professional. It is a common practice and an important component of day-to-day healthcare management, particularly in developing countries, where access to health services may be limited. Health science students are often believed to be self-medicated more frequently than the general population due to their medical knowledge. This study aimed to determine the prevalence of self-medication and associated factors among undergraduate students in private universities in the Banadir region of Somalia.</p> Methods <p>An institution-based cross-sectional study was conducted among 679 undergraduate students from private universities in the Banadir region. Participants were recruited using a convenience sampling technique. Data were collected using a self-administered questionnaire and analyzed using descriptive statistics and logistic regression to identify factors associated with self- medication.</p> Results <p>The study found that 67% of students practiced self-medication. Analgesics (50%) and antibiotics (38%) were the most used medications, primarily for headache (33.1%) and fever (18.7%). Students without prior training in antibiotic use were significantly more likely to practice self- medication, as were non-medical students compared with students enrolled in medical fields.</p> Conclusion <p>Self-medication was highly prevalent among Somali undergraduates, with frequent use of analgesics and antibiotics, particularly among non-medical students and those without prior training on antibiotic use. These practices pose risks, including adverse drug effects, delayed diagnosis, and contribution to antimicrobial resistance. Targeted educational interventions strengthened training on rational antibiotic use across university programs, and stricter enforcement of prescription-only regulations are recommended to promote safer medicine use.</p>