Background: The incumbent of medical professional is expected to be socially responsible and emotionally empathetic along with good communication propensity to fasten the doctor-patient relationship. Whilst doctor's proficiency to recognize a patient's perspectives, and convey such an understanding back to the patient; in our case, the empathy and compassion level of promising medical professional is unknown in Nepal. Thus, this study aimed to analyze the compassion and empathy score of final year's undergraduate students of four medical colleges in Nepal. Methods: Self-reported empathy measures were obtained using the Jefferson Scale of Physician-Student version. Results: The degree of empathy for the participants was 97.28 (SD = 14.44) with a median score of 96.00 and a range of 44 (min) to 133 (max). There was a significant difference on scores of the Jefferson scale of physician empathy between NMC Nepalgunj and BPKIHS (p = 0.00) and between NMC Nepalgunj and Manipal Pokhara (p = 0.00), as well as between UCMS and Manipal Pokhara (p = 0.044). These results were significant at the 95% confidence interval. Conclusions: The mean empathy score for the Nepali students is lower than medical students from developed countries but almost similar to medical students from other Asian medical students. The female Nepali medical students scored slightly higher than their male counterparts. Thus colleges have to develop academic programs to improve empathy and compassion among medical students through providing adequate time to consult with patient and faculties.