Background: Non-medical prescription drug use is an increasing problem among university students. Purpose: The present study investigated university students' involvement in non-medical prescription drug (NMPD) use and associations between use and other risky behaviors. Methods: A sample of 363 university students completed a four page survey assessing involvement in NMPD use and risky behaviors. Results: Results indicated that approximately one in three university students have used prescription drugs without a doctor's prescription. Pain medication (22.4%) was the number one misused prescription drug followed by stimulants (17.5%). Almost half of university students reported using NMPDs with alcohol. Logistic regression analyses revealed being male and being a junior or senior increased the odds of involvement in NMPD use. Additional analyses revealed engaging in NMPD use was associated with increased odds for cigarette use, marijuana use, and suicidal ideation. Discussion: Health professionals should educate students about the dangers of NMPD use and attempt to identify students at high risk. Translation to Health Education Practice: Prevention programs should be developed to target university students who may be at risk for misuse. (Contains 4 tables.)