Context: Inappropriate drug dose calculations indicate high risk of medication errors. Students and experienced nurses often lack confidence in math calculations. Assessing students’ self-efficacy regarding drug dose calculations is crucial for implementing effective changes in educational course. Aim: We aimed to evaluate the self-efficacy and knowledge of students about drug dose calculations. Settings and Design: The descriptive survey-based study included 100 undergraduate students of second year BSc Nursing, from the selected nursing colleges in Karad. Materials and Methods: Purposive sampling technique was used and collected data were analyzed using Instat software. Statistical analysis: Statistical analysis was performed using Instat software. Results: Out of 100, only 19% subjects were confident during calculations, whereas 86% were confident while administering drugs and 13% were competent during calculations, whereas 82% were competent while administering drugs. Subjects who performed calculations incorrectly were less confident than those who performed correctly. Knowledge scores of students were significantly associated with age. Conclusion: Students definitely face difficulties in drug dosage calculations. They exhibit less confidence and poor competence in math abilities. To improve their selfefficacy emphasis should be given on more practice sessions and effective curriculum. There is a great need for interventional research on large scale.