One out of every four people in their lives can be affected by mental health problems that alter their functioning, behaviour, and thinking patterns. In recent years, there has been an increase in mental health disorders among students worldwide. Positive mental health (PMH) has gained relevance in today’s fast-paced and demanding world, especially for university students, as it affects their ability to learn, achieve academically, and behave appropriately. This study aimed to investigate the levels of PMH and identify the association between PMH domains and socio-demographic and health-related variables among Faculty of Health Sciences (FHS) students at a rural university in South Africa. A quantitative, descriptive, and cross-sectional survey was conducted. Data was collected using a multidimensional PMH instrument and a socio-demographic and health-related questionnaire, from 354 undergraduate students who are registered for various programmes offered by FHS. The data were analysed using IBM SPSS version 29. Most of the students were black (99.2%, n = 351), single (72%, n = 255), received a study bursary from the government (78.5%, n = 278), hailed from a rural area (77.7%, n = 275) and residing at the university campus (74.6%, n = 246). The total PMH scores of the participants ranged from 4.24 to 4.97 suggesting moderate to higher PMH levels. Significant differences in mean scores were observed in the total PMH and domains of PMH across various socio-demographic and health-related variables. Gender (p = 0.037), age (p = 0.043) and field of study (p = 0.016) showed a significant association with total PMH score. The study’s findings highlighted the multi-dimensionality of mental health and justified the importance of evaluating the domains of PMH in university students. The disparities observed across different PMH domains underscore the necessity of embracing innovative approaches to achieve the most effective outcomes to improve mental health and the accurate management of symptoms in students.