Establishing and maintaining a highly-trained pharmaceutical workforce is crucial for serving the healthcare needs of the population. Globally, various factors have been associated with the decision of students leaving high school to pursue an undergraduate degree in pharmacy, however, this topic has not yet been explored in Vietnam. To explore the motivations of first-year undergraduate pharmacy students to study pharmacy at university. A cross-sectional study was conducted on 428 first-year pharmacy students enrolled in undergraduate pharmacy programs from across all universities in Can Tho, Vietnam, including one public university (193 students) and two private universities (235 students), from November 2022 to February 2023. Exploratory factor analysis identified five underlying factors associated with the choice of students to study pharmacy, with internal consistency assessed using Cronbach's Alpha ([alpha]): personal factors ([alpha] = 0.86), career ([alpha] = 0.88), advice ([alpha] = 0.74), reputation ([alpha] = 0.84), and promotion ([alpha] = 0.76). Of these factors, personal factors had the greatest impact (mean = 4.13), while the least influential factor was promotion (mean = 2.92). Compared to public university students, private university students were more influenced by career (p = 0.019), advice (p = 0.002), and promotion (p < 0.001) when making the decision to study pharmacy. This study identifies the factors associated with the decision to pursue pharmacy education. These findings may be of interest to educational institutions addressing how they attract students and meet the workforce needs of the pharmaceutical industry and healthcare system.