Purpose: To highlight the prevalence and severity of depression among undergraduate students in public and private universities in Karachi, Pakistan.

Methods: In this cross-sectional study a total of 408 undergraduate students from both public and private universities in Karachi, Pakistan completed Zung Self-Rating Depression Scale (SDS) questionnaire to appraise the presence and extent of depression among the participants. Their socio-demographic characteristics such as age, gender and course of study as well as drug use data were also collected and analyzed.

Results: Depression prevalence was 53.43 % (38.07 % for males and 61.00 % for females). A significant disparity in the prevalence of depression across ethnicity was observed. Less than 50 % (n = 163) of the students were satisfied with their duration of degree course work while 111 (27.20 %) participants were not sure about this. The intensity of depression increased with declining satisfaction level (Gamma = 0.264, p = 0.001) which affected the performance and results of students during their studies. A majority of the participants (89 %, n = 358) of our study have never used medicines to alter their mood.

Conclusion: The findings of this study highlight the importance of understanding the unique strains and mental health effect of university education on undergraduate students, especially female students.