Objective: To determine the level of and factors associated with empathy among medical students.Materials and Methods: This cross-sectional study surveyed all first- to sixth-year medical students at the Facultyof Medicines, Prince of Songkla University, at the end of the 2020 academic year. The questionnaires consisted of:1) The personal and demographic information questionnaire, 2) The Toronto Empathy Questionnaire, and 3) ThaiMental Health Indicator-15. Data were analyzed using descriptive statistics, and factors associated with empathylevel were assessed via chi-square and logistic regression analyses.Results: There were 1010 participants with response rate of 94%. Most of them were female (59%). More than half(54.9%) reported a high level of empathy. There was a statistically significant difference in empathy levels betweenpre-clinical and clinical medical students; in regards to empathy subgroups (P-value < 0.001). The assessment ofemotional states in others by demonstrating appropriate sensitivity behavior, altruism, and empathic respondingscores among the pre-clinical group were higher than those of the clinical group. Multivariate analysis indicatedthat female gender, pre-clinical training level, and minor specialty preference were factors associated with empathylevel. The protective factor that significantly improved the level of empathy was having fair to good mental health.Conclusion: More than half of the surveyed medical students reported a high level of empathy. The protective factorthat improved the level of empathy was good mental health. However, future qualitative methods, longitudinalsurveillance, or long-term follow-up designs are required to ensure the trustworthiness of these findings.