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Objectives To examine the perception of educational environment among clinical year students in Thailand using Dundee ready education environment measure (DREEM) and identify factors associated with the DREEM scores. Methods A total of 2,467 fourth- to sixth-year students from 34 teaching hospitals nationwide responded to a Thai version of DREEM questionnaire. Data on each student’s sex, year of study, size of teaching hospitals and GPAX were collected. Mean total DREEM scores and subscales were calculated and then compared across groups using t-test and one-way ANOVA. Results The overall student perception on educational environment was ‘more positive than negative,’ with the mean total DREEM score of 131.1 (SD=17.4). Similar findings were observed in all subscales. Mean total DREEM scores were lower in medium-size than small- and large-size teaching hospitals 129.9 (SD = 18.1), 131.9 (SD = 17.5) and 131.6 (SD=16.4) respectively (F (2,2422) =3.21, p=0.04). Sex and years of study was associated with certain DREEM subscales. Conclusions Clinical year medical students in Thailand were satisfied with their academic learning environment, with varying perceptions across different size of teaching hospitals. Repeat assessment of educational environment of medical schools over time is needed for monitoring changes after specific educational interventions being applied.