BACKGROUND: Vaccine hesitancy and reluctant had an important obstacle in achieving protection and population immunity against coronavirus disease 19 (COVID-19). It is essential to achieve high COVID-19 vaccination acceptance rates among medical students and health care workers to provide recommendations and counseling vaccine hesitant population. AIM: This study aims to identify level of COVID-19 hesitancy, attitude, knowledge, and factors that affect vaccination decision. MATERIALS AND METHODS: A cross-sectional study was done among medical students in Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq. Data collection was done through an online Google Forms questionnaire during 2021 from 810 medical students. RESULTS: A total of 810 adults’ medical students participated in this study. The majority of the study participants were female (488, 60.2%) while males were 322, 39.8%. Vaccine concept hesitancy among males was 65.21% and rest were vaccinated (34.78%) (OR = 0.13) (95% CI = 0.096–0.177) (p = 0.0001). Same hesitancy from COVID-19 vaccine was same with females (66.80%). CONCLUSIONS: This study evaluated and shed light on vaccine hesitancy among sample of Iraqi medical students toward COVID-19 vaccination program and considered medical students as leaders and guides in the health system for increased planning and education of the population for COVID-19 vaccine acceptability.