Recently, the incidence of poor sleep quality and anxiety levels has increased among university students. The psychological and physical factors that students commonly experience may also correlate with their ability to balance confidently during daily activities. This study aimed to examine the relationship between sleep quality, anxiety levels, and balance confidence among university students. A total of 217 participants, aged between 18 and 25 years, with no hearing loss or vestibular/balance disorder, no metabolic, neurological, or psychiatric diseases, and no sleep apnea, were included in the study. The Activities-Specific Balance Confidence Scale, Pittsburgh Sleep Quality Index, and Beck Anxiety Inventory were used. Anxiety level and poor sleep quality were negatively correlated with balance confidence ( r = −.323 for anxiety, r = −.293 for sleep quality, p < .001). In addition, a moderate positive correlation was observed between sleep quality and anxiety level ( r = .504, p < .001). Participants with good sleep quality had higher balance confidence scores than those with poor sleep quality ( p < .001). Similarly, those with mild anxiety levels had higher balance confidence scores than those with moderate or high anxiety levels ( p = .03). Poor sleep quality, an increase in anxiety, and a decline in balance confidence were interrelated among university students. These findings can aid the development of interventions to improve sleep quality, anxiety levels, and balance confidence among university students, thereby improving their health and wellbeing.