Aim: This study aimed to determine the patterns of physical activity (PA) and its association with gender and academic year among undergraduate medical students of a tertiary care hospital in South India. Materials and Methods: A cross-sectional study was conducted among undergraduate medical students from August to October 2022 at a tertiary care teaching hospital in South India. PA was determined using the self-administered long form of the International Physical Activity Questionnaire (IPAQ). Statistical analysis was performed using SPSS software. Results: A total of 223 students aged 18 to 25 years completed the questionnaire, with the majority being females (59.2%). Their median total PA (metabolic equivalent [MET] minutes/week) was 1320, with 2073 and 771 MET minutes/week among male and female students, respectively. Fourth-year students were the most physically active, with higher energy expenditure per week, followed by second-year, third-year, and first-year students ( p = .007). Out of the total 223 students, 141 (63.2%), 62 (27.8%), and 20 (9%) students belonged to low, moderate, and high PA levels, respectively. There was a greater proportion of students with low PA among females (70.5%) compared to male (52.7%) participants ( p < .001). Conclusion: Most undergraduate medical students had a low level of PA, especially females and students in the first academic year. To increase the PA levels among medical students, curricular reforms by incorporating sports/exercise training, and ensuring the availability of adequate facilities and trainers for sports in every college/university is warranted. Future research focusing on the exploration of barriers to PA and designing innovative strategies to promote PA among medical students is the need of the hour.