Background: Young adults, including medical students, are increasingly exposed to unhealthy lifestyle behaviors and early metabolic abnormalities that may predispose them to long-term cardiovascular disease. This constitutes a major public health challenge in South East Asia now-a days. Methods: A cross-sectional study was conducted among undergraduate medical students at Noakhali Medical College, Bangladesh, between October 2024 and June 2025. Behavioral, anthropometric, clinical, and biochemical data were collected using standardized protocols. Lifestyle factors included diet, physical activity, sedentary behavior, sleep duration, and stress. Anthropometric measurements comprised body mass index (BMI) and waist circumference, while biochemical assessments included 75-gm oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c) and lipid profile. Descriptive statistics and bivariate analyses using Chi-square tests were performed. Results: A total of 135 students (age: 21.0±1.9 years; 69.6% female) were included. The prevalence of overweight/obesity (BMI ≥25 kg/m²) was 28.9%, and similar numbers had central obesity. More than half of participants exhibited prediabetes (51.9%), while 64.4% had dyslipidemia and 13.3% met criteria for metabolic syndrome. Hypertension was present in 4.4% of students. Overweight/obesity was significantly associated with hypertension (p = 0.002) and dyslipidemia (p = 0.033), but not with sex, physical inactivity, sedentary behavior, dietary intake, glucose intolerance, or short sleep duration. Conclusion: Undergraduate medical students in Bangladesh demonstrate a high burden of cardiometabolic risk factors, including excess body weight, early dysglycemia, and dyslipidemia. These findings underscore the need for early, targeted preventive and health promotion strategies within medical education to mitigate future cardiometabolic disease risk in this critical population.