The prevalence of hookah smoking (i.e., tobacco smoked from a waterpipe) is increasing both in the United States and globally. Hookah use in the U.S. is particularly prominent among college aged individuals. Research has documented high rates of past 30- day hookah use among college students in the eastern U.S., ranging from 9.5% to 20%, with one studying documenting 30.6% reporting hookah use in the past year. However, there is limited research examining the prevalence in hookah use in different regions and among different subpopulations in the U.S. This study demonstrated a relationship between hookah use and psychosocial factors, as well as other health risk factors, among college students. We found that hookah use was positively associated with cigarette smoking, alcohol use, sensation seeking, and openness to experience; negatively associated with conscientiousness; and marginally associated with greater perceived stress. Personality characteristics should be further examined in relation to risk for hookah use and may be used as potential intervention targets for addressing hookah use.