To assess the prevalence of melatonin use and its perceived benefits among university students in different specialties in Saudi Arabia, a cross-sectional survey was conducted between March and June 2023. Data about demographics, time of melatonin use, perceived reasons for exogenous melatonin use, melatonin use in relation to exam periods, perceived safety, and adverse effects was gathered. Of 380 students, ~52% reported using exogenous melatonin for sleep disorders. Most participants reported using melatonin during and after exam periods. Additionally, several (n = 157; 75.4%) believed that its use was safe. The predominant use patterns were daily and as needed, and this study observed a higher rate of use compared with previous studies in Saudi Arabia. The most frequently reported adverse effect was headache (n = 36; 37.5%). A significant number of undergraduate male students in health specialties used melatonin. A high rate of melatonin use was noted during exam periods, which was attributed to sleep deprivation. Additionally, a significant number of students from private universities reported using exogenous melatonin. Melatonin use is common among university students. Future research should use a reliable psychometric measure to test its effect on university students' sleep quality and quantity.