Objective: To understand the self-health management ability of college students of Zhuang nationality in the economically underdeveloped areas of Guangxi and assoliated factors, and to provide support for improving the health of college students in economically underdeveloped areas. Methods: Five colleges and universities were selected in the economically underdeveloped areas of Guangxi, and 1 042 college students of Zhuang nationality were randomly selected to conduct self-health management ability surveys, and the influencing factors affecting self-health management ability were analyzed. Results: The self-health management ability of Zhuang college students in the economically underdeveloped areas of Guangxi scored (3.63±0.59) points. The scores of boys’ self-health management behaviors were higher than those of girls, which was statistically significant (t=2.92, P<0.01). There was a statistically significant difference in the total scores of cognitive and self-health management among students of different grades (F=8.03, 3.04, P<0.01). The dimensions and total scores of self-health management of medical students were higher than those of other majors, and there was statistical significance (P<0.01). The scores of behavior, environment and total scores of students with different self-assessment status were statistically significant (P<0.01). Regression analysis showed that professional, gender, and self-rated health were the main influencing factors of behavior and environment (P<0.01); gender, grade, and major were the main influencing factors of cognition (P<0.01); grade, professional, self-evaluation health were the main influencing factors of the total score of self-health management (P<0.01). Conclusion The Zhuang nationality students in the economically underdeveloped areas of Guangxi have higher self-health management ability, but their behaviors are not very good. They should be intervened and guided by different groups to improve the self-health management ability of Zhuang college students.