Background: The relationship between the sleep and food habits with exam performance is insufficiently addressed Aim: This study was aimed to assess the prospective relationship between sleep habits and food habits with academic performance in first year MBBS students Methods: This study was conducted between June to August 2014 at Sri Muthukumaran Medical College and included all the 150 students both males and females of 18-20 age group of first MBBS who were appearing for University examinations. A self-administered questionnaire was distributed to assess demographics, sleep and wake schedule, sleep habits, sleep duration and food habits. Results: The final analysis included 150 students (Females: 97, Males: 53). Sixty students (40%) had outstanding performance, and ninety students (60%) had average performance in their University examinations. The average group had a higher percentage of students who felt sleepy during morning hours. In contrast, the outstanding performance group had an earlier bedtime. Conclusion: Decreased nocturnal sleep time and increased daytime sleep are negatively associated with University examination performance in first MBBS students.