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Background: Neck pain is a common musculoskeletal complaint among university students and is frequently associated with prolonged study duration, poor posture, and extended use of electronic devices. Sustained non-neutral cervical postures during academic activities can increase mechanical stress on cervical structures, potentially leading to discomfort, reduced productivity, and impaired quality of life. Despite increasing recognition of posture-related neck pain globally, limited epidemiological data are available describing its prevalence and associated study behaviors among university students in Karachi, Pakistan. Objective: To determine the prevalence of neck pain attributable to study posture and to describe associated behavioral and ergonomic factors among university students in Karachi. Methods: A descriptive cross-sectional study was conducted among university students aged 18–30 years from multiple universities in Karachi. A total of 300 questionnaires were distributed using a non-probability convenience sampling approach, of which 288 eligible responses were included in the analysis. Data were collected using a structured questionnaire assessing demographic characteristics, study posture, study duration, break patterns, physical activity, ergonomic device use, and neck pain intensity measured using the Visual Analogue Scale (VAS). Statistical analysis was performed using SPSS version 27 with descriptive statistics and chi-square testing. Results: Among the 288 participants, 96.5% reported experiencing some degree of neck pain, with moderate pain being the most common intensity level (50.3%). Poor desk positioning during study was reported by 57.3% of students. Prolonged study duration was common, with 44.1% studying 4–6 hours daily. A majority of students (71.2%) reported not taking breaks during study sessions, while 62.5% did not use ergonomic devices. Longer study duration, lack of breaks, physical inactivity, and poor ergonomic practices were significantly associated with higher neck pain prevalence. Conclusion: Neck pain is highly prevalent among university students in Karachi and appears to be associated with modifiable study behaviors and ergonomic factors. Promoting ergonomic awareness, regular study breaks, and physical activity may help reduce posture-related neck pain among students.