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ABSTRACT OBJECTIVE: To evaluate the frequency and factors associated with smoking among female university students in Pakistan. METHODS: This cross-sectional survey was conducted in 4 cities (Karachi, Hyderabad, Multan and Lahore) of Pakistan. A total of 689 female students from 18 universities (including medical, engineering & social sciences universities) filled the questionnaire through convenient sampling method. Data analysis was done on SPSS 22. Binary logistic regression, with 95% confidence interval (CI) was used to determine the factors associated with smoking. RESULTS: Mean age at initiation of smoking was 16.65±2.46 years. Total frequency of smoking was 7.4% (n=51/689). Out of 51 students involved in smoking, 25 (49%) used shisha, 7 (13.7%) used Cigarette and 19 (37%) used both modes of smoking. Students who consider smoking necessary for Social gathering are 5 times more prone to smoke. Strong relationship between advertisement on Social media and smoking was found (p<0.05). Female students from fashion, business administration, media Sciences and engineering were more frequently indulge in smoking when compared to medical sciences (p<0.05). Less than 1% of cigarette smokers and 29.6% shisha smokers respectively were comfortable doing smoking in front of their parents. In females who were engaged in both kinds of smoking, 52.3% reported use of shisha before cigarette. Among non-smoker females 19%frequently visit shisha bar with family and friends. CONCLUSION: Although overall frequency of smoking was noted to be low among female students but parental approval of shisha, indulgence of shisha smokers in cigarette is alarming and cannot be ignored.