Study Design: Cross sectional study.

Place and duration: This study was conducted in Baqai medical university and Dow University of health sciences from 1st June 2013 to 31st March 2014.

Materials and Methods: A total of 300 students of all classes were selected by systematic random sampling technique (every 3rd student was taken). Unwilling and non-cooperative students were excluded. All the students were subjected to fill a pre-design and prepared questionnaire designed to find out the perceptions and practices of students regarding waterpipe (sheesha) smoking.

Results: The study showed that 138 (46%) of the students exactly involved in the practice of waterpipe (sheesha) smoking. 53(38%) D-pharm student while 48(35%) MBBS student and 37(27%) BDS students are involved in this practice.85 (28.3%) of the students used to smoke waterpipe (sheesha) in a café. 263 (87.7%) out of 300 students knew about the hazards of waterpipe (sheesha) smoking.

Conclusion: D-pharmacy students are mostly involved while MBBS are less involved and BDS are least involved. Most students knew about waterpipe (sheesha) and its hazards, more than half of them were involved in waterpipe (sheesha) smoking. Most of the students started smoking waterpipe (sheesha) because their friends smoked.