Background: Knowledge and a positive attitude are necessary for the successful reduction in the prevalence of and stigma surrounding human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). The rural youth is a vulnerable group because of a lack of knowledge and maturity, misconceptions, cultural beliefs, and taboos about HIV/AIDS. Objective: The study aimed to assess knowledge and attitude about HIV/AIDS among college-going rural youths in Vasai in Palghar district of Maharashtra. Materials and Methods: The proportionate allocation approach was used with the stratified random sampling technique to select a 10% sample from 5000 rural students from two colleges in Vasai. A total of 512 students from various academic streams consented to participate. A pretested, semi-structured questionnaire comprising 50 questions (in English only) was administered. It included details about their sociodemographic status, economic background, knowledge, and attitude about HIV/AIDS with a scoring system. Data were analyzed using Excel and Epi Info. Results: Of the total of 512 students, 89.78% of males and 85.37% of females were aware of HIV/AIDS. The science students obtained a mean score of 8.49, whereas the nonscience students obtained a mean score of 6.93. Only 57 students could write a few correct symptoms of HIV/AIDS. About 65.82% of students feel that testing is important, but only 33.01% were willing to get tested. When asked about shaking hands with or touching people living with HIV/AIDS (PLHAs), 79.69% said that merely touching does not transmit HIV/AIDS, but only about half of the students (51.95%) would actually shake hands with or hug a PLHA. Interpretation and Conclusion: Unlike many other studies, where knowledge was poor and therefore attitude also reflected poorly, rural youth in Vasai has fair knowledge, but their attitude toward HIV/AIDS/PLHA is unfavorable. Although Vasai is rapidly developing, and literacy levels are increasing, the misconceptions and social stigma persist. Therefore, having adequate knowledge is not sufficient; the attitude has to change as well.