Background: Pharmacovigilance plays a vital role in ensuring drug safety by monitoring and preventing adverse drug reactions (ADRs). Medical students, particularly MBBS students, form the future backbone of healthcare systems and must be well-versed in pharmacovigilance to ensure safe medication practices. However, existing literature suggests that knowledge, attitudes, and practices (KAP) regarding pharmacovigilance among medical students remain suboptimal. Aim: This study aims to assess the knowledge, attitudes, and practices related to pharmacovigilance among MBBS students. Specific objectives include evaluating their understanding of pharmacovigilance principles, assessing their perceptions and willingness to engage in ADR reporting, and identifying factors influencing their KAP, including age and gender. Methodology: A cross-sectional KAP study was conducted among MBBS students at Shimogga Institute of Medical Sciences, Shimogga. A structured questionnaire was used to collect data on demographics, knowledge, attitudes, and practices regarding pharmacovigilance. The sample size was determined using Cochran’s formula, and convenient sampling was employed. Data were analyzed using SPSS, with descriptive and inferential statistical methods, including chi-square tests and ANOVA, to assess associations between variables. Results: The study found that while a majority of MBBS students had heard of pharmacovigilance, their detailed knowledge and practical engagement in ADR reporting were limited. Attitudinal responses indicated a positive outlook toward pharmacovigilance, but barriers such as lack of training, complex reporting procedures, and limited institutional support hindered active participation. Gender and academic year were found to have statistically significant associations with certain KAP components. Conclusion: Despite recognizing the importance of pharmacovigilance, MBBS students demonstrated gaps in knowledge and limited engagement in ADR reporting. The findings emphasize the need for enhanced pharmacovigilance training and curriculum integration to improve KAP levels. Implementing structured educational interventions, practical workshops, and institutional support could foster a culture of drug safety awareness among future medical professionals.