Background Communication barriers in medical education can impede learning. Understanding these barriers from students' perspectives is crucial for developing effective solutions. The objectives of this study were to identify the barriers to communication in undergraduate medical education and their solutions from students' perspectives as well as to determine the demographic factors associated with these barriers. Materials and methods A cross-sectional study was conducted from May 2018 to July 2019 among undergraduate students at a medical college in Karnataka. Using a stratified sampling method, data was collected from 400 students via a pretested semi-structured questionnaire. The data was analyzed using descriptive statistics, and logistic regression analysis was performed to determine the association between demographic factors and barriers to communication. Results Students identified several communication barriers, primarily in the domains of language, environment, psychology, and teacher-related issues. Key barriers in theory classes included the use of medical jargon, overcrowding, faulty microphones, absent-mindedness, peer pressure, fast-paced teaching, monotonous sessions, and information overload. In practical classes, barriers were overcrowding, absent-mindedness, and fast-paced teaching, and for clinical case discussions, barriers included difficulty understanding the local language, overcrowding, and leg pain. Proposed solutions by students for theory classes included simpler explanations, smaller batches, microphone maintenance, interactive lectures, and breaks between classes. For practical classes, solutions were smaller practical batches, interactive sessions, and simpler explanations of topics, while for case discussion, solutions included optional local language classes, smaller groups, and better seating arrangements. Conclusion This study highlights key communication barriers in medical education and underscores the influence of demographic factors such as gender and academic year. The solutions proposed by the students are practical and could enhance communication and the overall educational experience if implemented in medical colleges across India.