Background: Most studies, in the absence and presence of lecture recordings, have shown that there is an association between lecture attendance and academic performance for students of the biological sciences, but it is not known whether this occurs when lecture attendance is low. The effect of accessing lecture recordings on academic outcomes is not clear. The aims were (i) to determine any association between lecture attendance and academic outcomes for students who had access to lecture recordings, (ii) to describe how students use lecture recordings, and (iii) to determine any association between accessing lecture recordings and academic outcomes.Methods: During the lecture in week 1 and workshops in week 2, written consent was sought from the students to undertake the study. Lecture attendance and lecture recording access were measured. To determine whether there was an association between attending lectures or accessing lecture recordings and academic outcomes, Pearson’s correlation coefficients were calculated.Results: Consent was forthcoming from 48 students (75%). The main findings in this study of lecture attendance and lecture recording access in second year undergraduate optometry students in a pharmacology course were (i) lecture attendance was very low (mean, 15%), (ii) there was no association between lecture attendance and academic outcomes, (iii) early in semester, most of the accessing of lecture recordings was shortly after the lecture was presented, whereas later in the semester, most of the accessing was prior to the examination, and (iv) there was a significant weak association between accessing lecture recordings and academic outcomes.Conclusions: It is possible that as lecture attendance decreases and students become more reliant on lecture recordings, the positive association between lecture attendance and academic outcomes is lost, and a positive association between accessing lecture recordings and academic outcomes emerges.