Introduction: Thriving and performing well in entry-level programmes is important to occupational therapy students, but also for the competitive status of the institutions providing their education. The literature is sparse concerning the factors of importance for occupational therapy students' academic performance in, and satisfaction with, their education programme. Method: This cross-sectional study explored sociodemographic-, relationship-, education-, and work-related variables and their associations with the students' academic performance and satisfaction with the education programme. The data were analysed with multivariate linear regression. Results: Participants were 123 students (mean age 24 years, 80 % female) enrolled in an undergraduate occupational therapy programme in Norway. Having prior experience of higher education was associated with better academic performance, whereas having occupational therapy as the highest priority line of study at entry, and spending fewer hours on self-studies, were associated with lower satisfaction with the education program. Conclusion: To improve academic performance, occupational therapy educators are encouraged to help students learn about the tasks, requirements, standards, and culture that constitute higher education. To improve satisfaction, it may be most efficient to target students who initially indicate the most interest in studying occupational therapy.