Purpose: Presenteeism is the productivity loss due to working with ill health. This paper aims to develop a presenteeism scale for students (PSS) and reveals its association with the academic achievement of undergraduate (Bachelor) students. Design/methodology/approach: This is a cross-sectional study based on a reputed public university in Bangladesh. The study collected data from 164 undergraduate students by relying upon the systematic random sampling technique. Findings: Nearly 70 percent of the study population have reported some health problems, with male students reporting frustration (59.6 percent) and female students reporting migraine (61.2 percent) as the most prevalent issues. Predictors such as gender, living status, television and social media use, absenteeism, physical activity, BMI (body mass index), hygienic meal intake, exhaustion score and PSS score have significantly influenced presenteeism and reduced academic performance. As many students face multiple health issues, it is recommended that the issue of presenteeism on university campuses be addressed. Originality/value: This study breaks from the conventional approach of studying presenteeism in business settings and expands knowledge in the education domain. Additionally, it examines the interconnection of primary health conditions, work impairment score, presenteeism and academic performance.