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Introduction: Are the education students receive prior to entering the university, based on critical thinking skills? Are their scientific abilities associated with this thinking style? This study was designed with the aim of evaluating critical thinking skills and its relationship with the achieved rank in university entrance exam in the students of Isfahan University of Medical Sciences. Methods: In a descriptive study, critical thinking skills of 89 randomly selected students who entered Isfahan University of Medical Sciences in the academic year of 2006-2007, and were spending their first semester was evaluated. Data was gathered using California standard test of critical thinking skills (form B) which was run officially. The attained scores were regarded as students' critical thinking skills criteria and were investigated considering its relationship with the students rank in university entrance exam. The data was analyzed by SPSS software using t-test and Pearson correlation coefficient. Results: The mean and standard deviation of students' scores in critical thinking skills was 12.48±3.23. There was no significant relationship between the rank in university entrance exam and the total score of critical thinking. Among domains of critical thinking, there was just a significant relationship between the domain of inference and student's rank in the university entrance exam, with a relatively low correlation. In two groups of doctorate (professional doctorate) and bachelor students, only in doctorate students and in the domain of deductive reasoning, there was a significant correlation between university entrance exam rank and critical thinking scores. Conclusion: It seems that students' critical thinking scores at the time of their entrance to the university are not so desirable and their rank in the university entrance exam is not related to these skills. Therefore, it is necessary to consider teaching and promoting critical thinking skills in the university educational planning. [ABSTRACT FROM AUTHOR]