A study among 248 physiotherapy students in Saudi Arabia examined sleep quality, well-being and their association with academic performance as measured by GPA. Females comprised 79.4% of the sample and the GPA distribution differed significantly by gender (p < 0.001). Overall, 70.6% of students had poor sleep quality according to the Pittsburgh Sleep Quality Index (PSQI), with a mean well-being score of 41.5 ± 8.9 and no difference between universities (p = 0.124). Sleep efficiency was positively associated with GPA (r = 0.150, p < 0.05), while sleep medication use was negatively associated (r = -0.130, p < 0.05). Prosperity scores were negatively correlated with PSQI daily dysfunction (r = -0.409, p < 0.001) and PSQI global scores (r = -0.327, p < 0.001). Regression analysis after adjusting for sex, study site, and academic level showed that shorter sleep duration (OR = 0.72, p = 0.011) and frequent use of sleep medication (OR = 1.48, p = 0.035) were predictors of lower GPA; male gender was also associated with lower GPA (OR = 4.31, p < .001). Poor sleep quality was highly prevalent, prosperity remained high, but was unrelated to GPA.