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This study explores the relationships between social cognitive factors and AS in a Chinese medical education context. The social cognitive model of academic satisfaction (SCMAS) was adopted as the theoretical framework. The study surveyed 123 medical institutions across China in 2021, 130,909 medical students provided valid data for the study. Demographic variables, financial pressure, and college entrance examination scores were first entered in Model 1, explaining 6% of the variance in AS. Social cognitive factors were entered in Model 2, explaining an additional 37% of the variance. Results show that social cognitive factors play an important role in predicting medical students’ AS. Intervention programs or courses aiming to improve medical students’ AS are advised to consider social cognitive factors.