This study aims to assess the associations among students' perceptions of climate change, university social responsibility (USR), and environmental sustainability practices at a medical university. It also aims to identify the factors associated with these elements. A cross-sectional self-report study was conducted with a total sample of 416 undergraduate students from a medical university in Taiwan during October 2019. Data gathered comprised sociodemographic characteristics, perceptions of climate change issues, environmental sustainability practices, measure for perception toward USR, and transportation modes. Chi-square test, Fisher's exact test, two-sample t test, and multiple linear regression models were used. Results of multiple linear regression demonstrated that the level of certainty in climate change existence (extremely and mostly certain vs somewhat or not certain at all, 1.45 [0.68]), score for usage of nonpublic transportation (per 1-point increase, 0.52 [0.25]), and students' perception toward USR (per 1-point increase, 0.14 [0.04]) were associated with the total score of environmental sustainability practice (R-square = 11.47%). In addition, school year (non-freshmen vs freshmen, -1.64 [0.65]) and environmental sustainability practices (per 1-point increase, 0.23 [0.06]) were associated with the total score of students' perception of USR (R-square = 6.57%). Promoting environmental sustainability among university students can be achieved by implementing USR-oriented courses or activities. Our research is pioneering in investigating and discussing the perceived USR and environmental sustainability practices among university students in Taiwan.