To clarify how students' awareness is linked to their understanding of Kampo medicine, we carried out a questionnaire and test for 94 fourth-year medical students (MS) following all the lectures at Yamaguchi University School of Medicine.Gender was not associated with performance in the test.MS having been admitted to an undergraduate program had a significantly better performance record in the test than did MS who had passed the usual university entrance examinations (P < 0.0001).MS who had experienced the efficacy of Kampo medicine had a significantly better performance record in the test than did MS who had not.Understanding of both the merits and demerits of Kampo medicine, a desire to see bedside teaching of Kampo medicine currently or in the future, and a desire to integrate Kampo medicine with primary care in the future were associated with a better performance record in the test.Multiple logistic regression analysis showed that admission to an undergraduate program (odds ratio (OR) = 6.9) and having experienced the efficacy of Kampo medicine (OR = 4.5) were independently contributing factors to a good performance record in the test.Taken together, these results suggest that experiencing efficacy and bedside teaching are needed to increase understanding of Kampo medicine for MS.