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Human papillomavirus (HPV) vaccination is a critical yet underutilized strategy for preventing HPV-related cancers in young adults. University students represent a key demographic for catch-up vaccination owing to their risk profile and transitional healthcare access. This review synthesized data from January 2015 to February 2026 to examine the trends, disparities, and determinants of HPV vaccine uptake in this population. Vaccination rates remain suboptimal worldwide, with pronounced disparities across sex, race/ethnicity, socioeconomic status, and geographic regions. Key barriers operate at multiple levels: individual (knowledge gaps, low perceived risk, hesitancy), interpersonal (lack of provider recommendations), and structural (cost, healthcare access). Promising evidence-based interventions include proactive campus health services, digital campaigns tailored to Generation Z, healthcare provider recommendations, and supportive policies. An integrated socioecological approach coordinating strategies across these levels is essential. This review highlights the urgent need for equity-focused multichannel interventions and policies to improve HPV vaccination coverage among university students worldwide.