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INTRODUCTION: Human immunodeficiency virus (HIV) infection is a major global public health issue, affecting millions of people annually. University students are among the risk groups in the community because of their high-risk behaviors. Few studies have been conducted on HIV/AIDS preventive behaviors and associated factors among university students. Therefore, focusing on these target populations is crucial because it will help university managers and different stakeholders be informed about the burden of the problem and take different measures to halt the distribution of the infection. OBJECTIVE: To assess the predictors of HIV/AIDS preventive behaviors among undergraduate Health Science University students in Northwest Ethiopia in 2022. METHODS: This study used an institution-based cross-sectional design with a single-population proportion formula, and participants were selected using a simple random sampling technique. Data were entered into Epi Data version 4.6.0.2 and exported to SPSS version 26 for cleaning and analysis, and the results were presented using text, graphs, pie charts, percentages, and frequencies. Bivariate and multivariable logistic regression analyses were used, and variables with a p-value of ≤0.25 in the bivariate analysis were entered into the multivariable analysis. A p-value of less than or equal to 0.05 in the multivariable analysis was considered statistically significant. RESULT: Out of 287 study participants, 284 of them responded completely, with a response rate of 99.0 %. Among the total respondents, 42.3 % (95 % CI: 37.7, 47.8) of the participants had poor HIV/AIDS preventive behavior. Younger age (AOR: 3.05; 95 % CI (1.243, 7.496)), low perceived susceptibility (AOR: 2.12; 95 % CI (1.179, 3.809), low perceived severity (AOR: 3.00; 95 % CI (1.636, 5.509)), high perceived barriers (AOR: 2.78; 95 % CI (1.487, 5.202)), and having poor HIV/AIDS preventive knowledge (AOR: 3.87; 95 % CI (2.170, 6.919)) were significantly associated with