Background: Grit, academic self-efficacy, and academic stress are crucial factors affecting a student’s ability to adapt to college. Objectives: The influence of grit on academic self-efficacy and academic stress among college physical therapy students was analyzed. Design: Questionnaire design. Methods: A total of 208 three-year undergraduate physical therapy students were surveyed using a structured questionnaire that assessed their grit, academic self-efficacy, and academic stress. The levels of each factor, the subfactors influencing each factor, and their correlations were analyzed. Results: Among college physical therapy students, having lower daily study hours was associated with lower grit and academic self-efficacy and higher academic stress. Younger students showed lower self-regulatory efficacy and self-confidence and higher levels of academic stress (P<.05). An analysis of the correlations of each factor revealed a significant correlation: the higher the students’ grit, the higher their academic self-efficiency and the lower their academic stress. Additionally, higher academic self-efficacy was significantly associated with lower academic stress (P<.001). Conclusion: To enhance the grit and academic self-efficacy of three-year college physical therapy students and reduce their academic stress, it is necessary to manage their learning time, develop educational support programs according to age, and apply various teaching methods.