Objective To investigate the current situation of student engagement among medical college students and explore the impact of demographic characteristics on the student engagement of medical students, so as to inform the improvement of student engagement and teaching quality of medical colleges. Methods From February to March 2022, a questionnaire survey was conducted among 1 927 students of 6 majors including clinical medicine in Nanjing Medical University using stratified random sampling. Correlation analysis and multiple linear regression were used to analyze the relationship between demographic characteristics and student engagement. Results The score of medical students′ engagement was (3.53±0.56). Correlation analysis showed that only-child status (r=-0.048), grade (r=-0.105), achievement ranking (r=0.177), family location (r=0.103), parents′ education level (r=0.110, r=0.121), and annual family income (r=0.090) were associated with medical students′ engagement (P<0.05). Multivariate linear regression analysis showed that grade, achievement ranking, mother′s education level and annual family income are influencing factors of medical students′ engagement. Conclusions Overall, the student engagement of medical students is good and is affected by many factors. Medical colleges should pay more attention to the learning situation of medical students, then improve the medical students′ engagement.