Introduction Mathematical ability and numeracy skills are fundamental requirements for healthcare professionals undertaking patient management in a range of healthcare settings. The objective of this study was to ascertain the mathematical and drug calculation ability of undergraduate paramedic students at an Australian university in the state of Queensland. Methods This study utilised a cross-sectional study design with a previously used paper-based questionnaire to elicit responses about a range of mathematical calculations. A total of 185 Bachelor of Paramedicine students were eligible for this study. The drug calculations were provided using common pre-hospital management scenarios plus additional basic mathematical calculations. Students had no knowledge of the study before receiving the questionnaire at the end of a lecture. Descriptive and inferential statistics were used to report on demographic information and comparisons. Results There were 139 (75.1%) students who participated. Females comprised 59% of the total students with most students less than 25 years of age. Three (2.2%) students answered all questions correctly, however 56 (40.3%) students scored 50% or less. There were 102 (73.4%) conceptual errors, 111 (79.9%) arithmetical errors, and 29 (20.9%) computational errors. There was no statistically significant difference between females and males for the total of correct answers or the types of calculation errors. Conclusion Results from this study demonstrate that paramedic students from an Australian university struggle to solve basic mathematical calculations unaided in a classroom environment. Universities need to ensure mathematical capability with mastery testing, so they are safe when administering drugs on entering the workforce.