BACKGROUND: Physical ailments and mental illness among college students are surging in recent years, which warrants urgent and comprehensive health research. OBJECTIVE: To investigate whether there is a disparity in allostatic load between medical and non-medical college students, and to identify the influencing factors on allostatic load. METHODS: A cross-sectional study involving 8,253 college students was conducted. We used modified Poisson regression analysis of generalized linear models to examine allostatic load between the two groups of students based on biological, psychological, and sociological factors. RESULTS: The prevalence risk of allostatic load in non-medical students was significantly higher than that in medical students (18.9% vs. 14.1%, P <
0.001). Modified Poisson regression revealed that risk factors like non-medical background (RR = 1.200, 95%CI 1.088-1.324), being female (RR = 1.121, 95%CI 1.004-1.251), history of hospitalization (RR = 1.170, 95%CI 1.053-1.300), alcohol drinking (RR = 1.321, 95%CI 1.034-1.687), total stress (RR = 1.042, 95%CI 1.014-1.070), abnormal illness behavior (RR = 1.106, 95%CI 1.079-1.134), anxiety (RR = 1.214, 95%CI 1.055-1.396), depression (RR = 1.230, 95%CI 1.051-1.440), somatization (RR = 1.319, 95%CI 1.147-1.517), and insomnia (RR = 1.811, 95%CI 1.610-2.036) were positively correlated with allostatic load, while protective factors like originating from the western region (RR = 0.682, 95%CI 0.546-0.851, P = 0.001), studying for more than 4 h per day, especially 6-8 h (RR = 0.748, 95%CI 0.657-0.852), exercising for 0.5 to 1 h (RR = 0.900, 95%CI 0.814-0.995), having a high level of global well-being (RR = 0.930, 95%CI 0.903-0.957), and multi-dimensional health perception (RR = 0.753, 95%CI 0.681-0.833) were negatively correlated with allostatic load. CONCLUSION: This study proposes a multidimensional approach to understanding the health of college students. Non-medical and medical students show differences in health perception, behavior, lifestyle, emotional problems, and the social environment, leading to varied allostatic load risks and necessitating tailored health interventions. CLINICAL TRIAL REGISTRATION: Not applicable.