Background: Health literacy is one of the most critical aspects of health promotion. Limited health literacy is concerned with adverse health outcomes and a huge financial burden on society. However, the gap exists in the knowledge of health literacy, especially among undergraduates. The purpose of this study was to assess the levels of health literacy and its socio-demographic determinants among undergraduate students of Tribhuvan University, Nepal.

Methods: A web-based cross-sectional survey was conducted to recruit 466 undergraduate students proportionately from five institutes of Tribhuvan University, Nepal. The 16-item short version of the European Health Literacy Survey Questionnaire was used to measure students’ health literacy levels. IBM SPSS version 20 was used to analyze the data. Associated factors were examined using Chi-square tests.

Results: 61.2% of students were found to have limited health literacy (24.7% had “inadequate” and 36.5% had “problematic” health literacy). Teenage students (OR = 2.13, 95% CI: 1.22-3.70), students from non-health related majors (OR = 1.9, 95% CI: 1.25-2.9) and students with poor financial status (OR = 2.39, 95% CI: 1.15-4.96) were more likely to have inadequate health literacy. Students scored high on dimension dealing with understanding health information while they scored low on dimension dealing with appraising health information.

Conclusions: The majority of the undergraduates were found to have limited health literacy. Age, student’s sector, place of origin, and self-rated financial status were found to be significantly associated with limited health literacy. This study indicates university students should not be assumed to be health-literate and interventions to improve students’ health literacy especially for those whose majors are not health-related should be implemented. Further studies using a longer version of the health literacy survey questionnaire to explore more on determinants of health literacy are recommended.