Background Worldwide, death by suicide is a leading cause of death among young people, and students of higher educational institutions constitute a vulnerable group. This study aimed to determine the lifetime prevalence and associated factors of suicide attempt among students of a higher education institution in Nelson Mandela Municipality. Methods A cross sectional study was conducted among students of East Cape Midland College in Nelson Mandela Municipality. The participants were selected by stratified random sampling and a standardised self-administered questionnaire was used to collect data. Results The prevalence of lifetime suicide attempts was 16.0% among the participants. Multivariate logistic regression analysis revealed higher odds of suicide attempts among participants who: experienced bullying (OR: 1.66, CI: 1.05–2.61; p < 0.001), had underlying medical conditions (OR: 3.27, CI: 2.08–5.14; p < 0.001), had abnormal body weight perceptions (OR: 1.64, CI: 1.03–2.62; p < 0.05), had experienced sexual abuse (OR: 5.72, CI: 2.86–11.45; p < 0.001), or had someone very close who had experienced sexual abuse (OR: 1.77, CI: 1.02–3.05; p < 0.05). Conclusion This study identified history of sexual abuse, bullying, perceptions of abnormal body weight and underlying medical conditions as associated risk factors of suicide attempts among the participants. The high prevalence of suicide attempts among the participants (16%) demonstrates the urgent need for campus-based interventions and prevention strategies aimed at addressing the identified associated factors.