Sporting has a profound effect on the physical, mental and social well-being of individuals. There is a strong scientific evidence that physical inactivity is a major risk factor for non-communicable diseases such as diabetes cancers and coronary heart disease. University students are busy and tired with their heavy academic schedules. Therefore, it is good to promote healthy lifestyle choices among university students. The objective of the study was to assess the tendency and the attitude changes towards sports activities among the first year undergraduate students at the Faculty of Medicine, University of Kelaniya. Furthermore, we sought to identify how these students’ cognitive changes and their participation in sports affect their academic discipline. This study was based on a self-administrated questionnaire on 141 (59 male & 82 female) first year students at the Faculty of Medicine, University of Kelaniya. The software program SPSS 21 was used to analyze the gathered data. Amongst the 141 students, 78 (55.3%) were not involved in sports before entering the medical faculty. The main reasons were not enough time (51.2%), fear of disturbances to studies (25.6%) and parental oppression (6.4%). There were 134 (95%) students who wished to participate in the sport during their undergraduate years. The main reasons for their opting to participate in sports during undergraduate years were to achieve a healthy and balanced life (34.9%), for mental relief (28%), to meet new friends and for feeling of win and victory. Most of the students preferred racket sports (37.7%) and general fitness programs (27.2%) whereas some preferred indoor (15.3%) and outdoor sports (12.5%). Only a few students opted for martial arts (6.9%). In conclusion, most of the students were not engaged in sports before entering the university. But after entering the faculty, many students have a fresh mind and a penchant for sports. We also identified the reasons that affected their negative and positive attitudes towards sports activities.