University student's smoking is a significant public health problem. It is estimated that, globally, every fifth medical student is a smoker. So far, no research dealing with cigarette smoking among medical students has been conducted in the countries of the Western Balkans. The aim of this study was to examine the prevalence and risk factors of cigarette smoking among Western Balkans medical students. A cross-sectional study was conducted among 2452 students from 14 medical faculties in the Western Balkans (Republic of Slovenia, Republic of Croatia, Bosnia and Herzegovina, Republic of North Macedonia and Republic of Serbia). The data were gathered through an online survey. There were significantly more non-smokers than smokers among medical students. Only gender and parents smoking status were statistically significantly associated with students smoking status. The smokers were more often male students, who lived in urban areas prior their studies, and whose parents were both smokers. With the aim of monitoring and enhancing student population health, it is necessary for public health activists and health officials to continually survey the students' smoking status in order to recognize the smoking influencing factors, and form and take on appropriate activities to improve the prevention of cigarette smoking among students, as well as motivate those who smoke to give up smoking, which would contribute to improving the health of the student population.