Background:
The manufacturers of e-cigarettes are actively marketing their product by using electronic and social media. However there is scarcity of data regarding it use and perception among medical students of a developing country like Pakistan.

Methods:
A Cross sectional survey was conducted from 1^st July till 30^th September 2016 in five medical universities of Sindh, Pakistan. A self-administered questionnaire was used, a total of 500 medical students consented to participate in the study

Results:
The mean age was 21.5±1.7 years and 58% were females. Over 65% had knowledge about e-cigarettes and majority were tobacco user (87.6%, p< 0.001). The frequency of e-cigarette use was 6.2% while daily use was 1.2% and was found higher among tobacco user 13.9% and males 74% (p< 0.001). E-Cigarettes were mostly perceived as less harmful than tobacco cigarettes (39%), helpful in quitting smoking (27%), associated with respiratory diseases (36%), addictive (36%) and not safe for pregnancy (44%). E-cigarette users were found to be more indulged in other tobacco products including conventional cigarettes (80.6%), shisha (83.9%) and smokeless tobacco (38.7%).

Conclusions:
Although the use of e-cigarettes among medical students is low but most of the students who took on e-cigarettes ended up as a dual user rather than quitter.