Introduction: This study examined prevalence of academic failure and the risk factors that influence suicidal behaviour among medical students in Nigerian universities.

Aim: To determine the prevalence level of academic failure among medical students in Nigerian universities, identify the risk factors leading to suicide behaviour, and ascertain the strategies adopted by the universities for handling academic failure.

Methods: The study adopted a cross-sectional design, using 108 Year 4 undergraduate medical students in South-south Nigeria, who made up the study's sample. Data were generated using a questionnaire created on Google form tagged "Academic Failure and Suicide Behaviour Questionnaire" (AFSBQ), which was self-administered by the medical students.

Results: There was a moderate prevalence level of academic failure in the MBBS examination; and the highest risk factor associated with suicide was undisclosed depression/mental illness. The strategies employed for handling academic failure included displaying students' results on the notice boards, among others.

Discussion: The findings of this study shows evidence of the link between academic failure and suicide behaviour, and similarities in the respondents' perceptions of the risk factors associated with suicide behaviours.

Conclusion: Medical educators should devise better means of communicating the results of the MBBS examination and underachieving students should be notified of their continuous abysmal performance before the examinations to lessen the impact of the negative report and stigma. Medical students should be referred to the counselling Centre for expert intervention to prevent suicide.