Background The absence of a culturally adapted and validated Smile Aesthetics Scale for Peruvian university students reveals a significant gap in aesthetic dentistry and public health research. Addressing this gap is essential for accurately assessing dental aesthetic satisfaction within this demographic, ensuring the scale’s relevance and effectiveness across Spanish-speaking cultures. The aim of the study was to translate, culturally adapt, and validate the Smile Aesthetics Satisfaction Scale for Peruvian university students. Methods This research was applied, with an instrumental, cross-sectional, and descriptive design. Face validity was conducted with 10 students through unstructured interviews. Content validity was carried out by three experts. The validation of psychometric properties was performed on 190 students recruited through university dentistry social networks using simple random probability sampling. The Aiken test was used for face and content validity. Construct validity and internal consistency were examined through principal component and exploratory factor analysis, using promax and varimax rotations, and internal consistency was assessed with Cronbach’s Alpha. Results Face and content validity confirmed that the items were relevant and applicable, highlighting the significance of the construct evaluated within the specific cultural context of the research. The adapted scale reflected high content validity, with a global Aiken’s V of 0.83, emphasizing the clarity, coherence, and relevance of the items according to expert evaluation. The psychometric properties of the adapted scale were exceptional among the student population, evidenced by a Cronbach’s Alpha of 0.889. Conclusions The translation and cultural adaptation process of the Smile Aesthetics Satisfaction Scale has proven to be successful not only in terms of coherence and fidelity with the original instrument but also in its applicability and relevance within the context of university dental students.