Purpose: The purpose of this paper is to investigate how and why Saudi Arabian students engage in specific health risk behaviours (HRBs), and if there are gender differences. Design/methodology/approach: In order to find out the situation regarding university students in Saudi Arabia, quantitative data were collected by administering questionnaires to 722 respondents, and qualitative data were collected using a series of interviews with 17 students. Findings: The findings of this mixed methods sequential explanatory study suggest that lifestyle and personal factors, as well as economic, social, policy and other aspects of the environment played a significant role in influencing students' HRBs. Recommendations for mitigating HRBs among these students and other youth in the Saudi Arabian context are provided. Originality/value: This paper addresses an important gap in the research on HRBs among university students from the perspectives of students.