Smoking prevalence has been on the rise among university students in Nigeria despite the high awareness of harmful effects of smoking on health irrespective of the substance smoked, leading to death of millions annually. The aim of this study is to determine the prevalence, knowledge of health effect and attitude towards smoking among students of Alex Ekwueme Federal University Ndufu Alike, Ebonyi State. This was a cross-sectional descriptive study conducted at Alex Ekwueme Federal University Ndufu-Alike Ebonyi State between May and August, 2020. Structured questionnaires were distributed electronically to the participants. The data were analyzed using Statistical Package for Social Sciences (SPSS) version 23.0. Descriptive statistics were used to summarize data and data were presented in frequency tables. Pearson correlation and Chi-square were used to show relationship and compare between variables. The overall prevalence of smoking was 35.25%. Majority (70%) of the participants between the age group of 30 and 34 years were smokers. Among male students, the prevalence of tobacco smoking was 43% and it was 18% in female subjects. The two major factors that led to smoking among the students were curiosity (16.75%) and friends (16%). The smoking prevalence among the students include cigarette smoking-12.5%, shisha smoking-4.25%, cannabis smoking-7%, cigarette and shisha-2.75%, cigarette and cannabis-6.25%, cannabis and shisha-1.5% and all the three 1.0%. A moderate significant positive correlation exists between ever smoked and knowledge of health effect of smoking (p<0.05). The overall smoking prevalence of cigarette, shisha and cannabis was high. A good knowledge of health impacts of smoking and positive attitude towards smoking was found among the students.