Introduction: John Flavell in mid-1970s defined Metacognition as thinking about one’s own thinking and its regulation. Then in 1985 he further explained that one’s metacognitive base comprises what one has learned through various cognitive experiences. Over the past four decades, a considerable amount of work has been done in this field with quite a lot of literature published on the construct of Metacognition. No study has yet been done on evaluation of Metacognition levels among undergraduate medical students in Pakistan. Aim: The objectives of this study are to: Identify the Metacognition levels of undergraduate medical students in Pakistan;demonstrate the effect of Metacognition levels on academic performance; demonstrate difference in Metacognition levels in 1st year and 2nd year MBBS students with A levels and FSc background and finally to demonstrate the effect of gender on Metacognitive levels. Methods: A cross sectional study was conducted on 186 undergraduate MBBS (first year and second year) students of UCMD, Lahore. A structured Metacognitive Awareness Inventory (MAI) tool was used. Results: The results indicate that medical students have high metacognitive levels. Students having better Metacognition have shown significantly better academic performance as compared to those having low Metacognition levels. There is a significant impact of background of study and male gender on Metacognition levels but academic performance is not effected by these two factors. No significant difference was found in Metacognition levels of 1st and 2nd year students due to a small age gap in selected sample population.