Effective communication between physicians and patients is fundamental to quality healthcare. While technological advancements have improved many aspects of medicine, communication skill gaps persist, particularly in multicultural and multilingual countries like Lebanon. To assess the level of each communication skill among medical students in Lebanese universities following the European teaching curriculum, and to identify sociodemographic, academic, and behavioural factors associated with those skills. A cross-sectional study was conducted during the 2024–2025 academic year among 428 medical students from three Lebanese universities adopting the European teaching curriculum: Beirut Arab University (BAU), Lebanese University (LU), and Université Saint-Joseph de Beyrouth (USJ). Convenience sampling was used. Data was collected via an online questionnaire that included socio-demographics, personal characteristics, and the “Interpersonal Communication Skills Inventory.” Data were analysed using SPSS version 24. Associations were examined using bivariate analyses (chi-square and Fisher’s exact tests) and multivariable ordinal regression for each communication skill, with p < 0.05 considered statistically significant for all analyses. The strongest skill was sending clear messages, while major deficiencies were found in listening, getting and giving feedback, as well as handling emotional interactions. Significant associations were found between different communication skills and factors such as mandatory rotations ( p = 0.01), prior communication skills training ( p < 0.001), gender ( p = 0.027), sibling order ( p = 0.032), and mobile use (non-work screen time) ( p = 0.02). Communication skills among Lebanese medical students vary considerably and are influenced by multiple factors including academic exposure and sociodemographic elements. Early interventions and tailored training programs may bridge existing communication gaps in medical curricula.