OBJECTIVE The aim of this study was to assess medical students' perception of pharmacological cognitive enhancement (PCE) with methylphenidate and to determine whether this perception differs between junior and senior medical students. METHODS The second and fifth year medical student groups of 2017 at a specific university completed self-administered questionnaires in order to investigate if there were a difference in their attitudes towards methylphenidate use for PCE. RESULTS A total of 353 students were included as follows: 135 second year and 218 fifth year students. Fifth year students were more aware of PCE with methylphenidate than second year students (94% versus 87%; p value = 0.02). Many students (second year = 86%; fifth year = 71%; p value = 0.2469) were of the opinion that methylphenidate could enhance academic performance. Sixty-six percent of all the students were concerned about the fairness of PCE; 93% were concerned about the harmfulness of methylphenidate. There were no statistical significant differences in the attitudes towards methylphenidate use for PCE between the two groups of junior and senior students. CONCLUSIONS In both groups, the majority of students were against the use of methylphenidate for PCE in students without attention deficit and hyperactivity disorder. Their attitudes regarding the use of methylphenidate for non-medical purposes did not differ significantly. Addressing the topic of PCE with medical students is essential, and the impact on their practice can be an important direction for future research.