Objective To investigateand analysis medical students′ cognition and evaluation of and participation in extracurricular research and its influencing factors, and to provide empirical evidence for optimising the design of extracurricular research and promoting the improvement of students′ comprehensive ability. Methods A cross-sectional questionnaire survey using cluster sampling method was conducted in July 2023 with 223 undergraduate students majoring in Preventive Medicine and Labor and Social Securityfrom the School of Public Health, Southeast University, class of 2018~2022 as the study population. The questionnaire was designed by the research team and distributed through the Questionnaire Star platform.The survey content mainly included basic information, extracurricular research cognition and evaluation, participation, motivation, among others. Cognition and evaluation of extracurricular research andthe main reasons and considerations of students from different grades and majors to participate in extracurricular research were analysed by Mann-Whitney U test and χ²test. Logistic regression model was used to analyse the influencing factors of whether to choose a certain extracurricular research activity. Results The Likert scores in understanding, necessity, satisfaction, and learning outcomes of extracurricular research oflower grade students were all lower than those in the higher grade[(2.46±0.71) vs.(2.95±0.59), (3.00±0.76) vs.(3.33±0.64), (2.46±0.84) vs.(2.76±0.79), (3.11±0.73) vs.(3.41±0.55), all P<0.05]. Extracurricular research generally affects the first classroom. There were differences in the types of extracurricular research activities tended to be chosen by different grades, the factors prioritised, and the motivation to participate in the programme across different majors (P<0.05). Gender, grade level, and motivation influenc the choice of specific activity types. Personal interest had a greater influence on the choice of self-employment.Conclusions Medical students generally have a positive cognition and evaluation of extracurricular research, but the cognition of lower-grade students is not optimistic. Factors such as gender, grade, professional background and participation motivation influence the choice of activities.Institutions should strengthen the popularity and guidance of extracurricular research activities in the lower grades, establish an all-round and multi-level extracurricular research system, strengthen the guidance and practice opportunities for independent entrepreneurship education, and increase the time for students to learn independently, so as to optimise the mode of extracurricular research, and stimulate the enthusiasm of students′ participation and creative inspiration.