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Background: Psychoactive substance use is a proliferating public health and social problem leading to negative multi-dimensional impact especially among young people. This study was done to determine the prevalence and factors predisposing to psychoactive substance use among undergraduates in University of Uyo, Nigeria.Methodology: This was a cross-sectional descriptive study carried out among 350 undergraduates in the University of Uyo, Nigeria between March and July 2016. Data collection was done using a self-administered structured questionnaire and was analyzed using the Statistical Package for the Social Sciences, version 23.Results: The mean age of the respondents was 21.57±1.96 years. The prevalence of psychoactive substance use was 27.5% and was more in females (37.7%) than males (18.2%). Peer group influence (94.3%), Stress (70.5%), Curiosity (58.7%), were the most common factors perceived to predispose to psychoactive substance use among undergraduate students. Among the 89 substance users in the study, alcohol 89 (100.0%), codeine 71 (79.8%), tramadol 66(74.2%) and cigarette 37(41.6%) were the most commonly used substances. The commonest source of substances was from friends 76 (85.4%), while the commonest reasons for substance use were to boost confidence, 82 (92.1%) and to read for exams, 76 (85.4%). A statistically significant association existed between substance use and age, sex, intra family relationship, family member substance use, peer group use of psychoactive substance and academic performance (p |