Objectives The purpose of this study was to multicultural awareness, multicultural self-efficacy, and cultural competency in health care college students and to identify factors affecting cultural competency. Methods Data were collected using self-report questionnaires from 277 health care college students who were 1st and 4th years of the college in H city and D city. The data were analyzed using SPSS/WIN 29.0 program with descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficients, and hierarchical multiple regression. Results First, health care college students had high levels of multicultural awareness (5.37±0.53), multicultural self-efficacy (5.05±0.71), and cultural competency (3.70±0.75). Second, there was a significant difference in cultural competency according to age (F=3.253 p=.040), major (F=5.013, p=.002), presence of foreign friends (t=-2.810, p=.006), experience to taking multicultural lectures (t=-2.348, p=.020), and perception of the need for multicultural education (F=10.370, p<.001) among health care college students. Third, multicultural Competency had a statistically significant positive correlation with multicultural awareness (r=.406, p<.001) and multicultural self-efficacy (r=.651, p<.001). And multicultural awareness had a statistically significant positive correlation with multicultural self-efficacy (r=.583, p<.001). Fourth, as a result of hierarchical multiple regression analysis, the factors significantly influencing the cultural competency were major (nursing) (β=.140, p=.025), major (emergency medical technology) (β=.115, p=.043), multicultural self-efficacy (β=.572, p<.001), and a total explanatory power was 43.8% (F=20.566, p<.001). Conclusions These results suggest the development of a multicultural educational program that utilizes a multicultural self-efficacy promotion strategy and reflects the characteristics of the major to enhance the cultural competency of health care college students.