Background: Body piercing is an increasingly common practice globally. This practice is associated with several health concerns which vary from tissue trauma, allergic reactions, keloids, and infections which can range from local to systemic and transmission of blood-borne infections such as HIV and hepatitis B and C virus. There is limited data in Nigeria on the prevalence, medical and social consequences of body piercing. Hence, this study sought to examine the trends, motivation and complications of body piercing among undergraduate students with body piercings in a university in southwestern Nigeria. Methodology: A cross-sectional study was conducted between August 2022 and January 2023 among undergraduate students with body piercings in a private University in Southwestern Nigeria. Self-administered, semi-structured questionnaires were used to obtain data from the 137 participants. Results: The mean age of the respondents was 19.43 ± 1.52 years and 59.1% were females. The number of body piercings among the participants ranged from 1-9 with 43.8% having 2 body piercings. The ear lobe was the most commonly (66.1%) pierced site. Males were more likely to pierce their tongues while females were more likely to pierce their navels. The predominant motivations for obtaining body piercings were fashion (40.0%), self-expression (36.2%), and creative expression (21.5%). Most (50.0%) of the participants had piercings done by staff in a professional piercing shop, a piercing needle was the most common instrument used (42.6%) and most (79.6%) of the participants reported sterilization of the piercing instrument before use. Only 8.8% of the participants reported complications which ranged from post-piercing bleeding (2.2%), and haematoma formation (4.4%) to tearing of skin (2.2%). Conclusion: Due to the increasing popularity of body piercing, there is a need to increase awareness about the hazards associated with body piercings among piercers, their clients and the health services.