Significant disparities in academic performance that may be associated with specific demographics can be utilized for supporting diverse student cohorts. Strategies can be developed for students to enhance equity and inclusivity in undergraduate occupational therapy education to ensure student success. This study aimed to determine the predictive demographic factors influencing academic performance among first- and second-year undergraduate occupational therapy students at a university in South Africa. A quantitative, cross-sectional design was utilized, and the sample included 129 first- and second-year students. Data were collected retrospectively from university records and student dashboards. Key demographic and academic variables were analyzed, including personal and geographical information, parental education, funding, university enrollments, and academic performance. Data analyses included descriptive statistics for the overall cohort and students who failed courses in the first and second year. Logistic regression was utilized to identify patterns and relationships between the variables and academic performance for students who failed ranging from 2 to 48 students per course in first year, and 7 to 50 students who failed per course in second year. The study indicates that demographic factors influenced academic performance among occupational therapy students in South Africa, but their impact varied by course. Gender, age, and geographical context were noteworthy predictors of academic performance, particularly highlighting the challenges faced by male students and students from rural contexts. These insights contribute to understanding the complex nature of demographic factors affecting student outcomes, particularly in the context of resource-constrained countries in the global South. The study advocates for individual support and targeted interventions to address diverse student needs, moving away from a one-size-fits-all approach.