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ABSTRACT Background: A measurement of environmental change that has both good and negative effects is perceived stress. The undergraduate medical curriculum demands constant dedication and discipline owing to the nature and vastness of the course, medical students may be negatively impacted by perceived stress and interpersonal reactivity, which can lead to alcohol and other drug abuse and suicide. This effect persists even after a medical student graduates and becomes a doctor. Aim: To study stress, risk-taking, self-harm behavior, and resilience in students of 1 st year MBBS. Materials and Methods: This cross-sectional, observational study was carried out on students of 1 st year MBBS from a medical college in the Western part of India. After obtaining the Institutional Ethics Committee approval and informed consent, 250 students were administered a self-made sociodemographic questionnaire, perceived stress scale, resilience scale, risk-taking, and self-harm inventory. Data were analyzed using the SPSS program using appropriate statistical tests. Results: Analysis of scores on the rating scales revealed that female students had significantly lower scores on risk-taking, risk-taking + self-harm, and brief resilience scale. Perceived stress was significantly positively correlated with risk-taking, self-harm, and risk-taking + self-harm in female MBBS students. However, perceived stress was significantly positively correlated with risk-taking, self-harm, and risk-taking + self-harm and negatively correlated with resilience in male MBBS students. It was found that out of the whole sample, 8% were under very little stress, 82.8% were under moderate stress and 9.2% were under severe stress. Conclusion: There is a high prevalence of stress in students of 1 st year MBBS. Orientation programs in the form of workshops for the 1 st year medical students can be conducted for coping strategies for stress.