The recent global increase in argileh use represents the modern renaissance of an old public health threat and a new tobacco epidemic. This study examined argileh smoking knowledge and attitudes in a sample of university students in Beirut as determinants of argileh smoking. Data were collected cross-sectionally through self-administered questionnaires from 416 students at the American University of Beirut through stratified cluster sampling. The proportion of ever-smokers in this study was 43%, compared with the 30% reported 4 years ago. A total of 28.3% of the surveyed students were current argileh smokers, and the average initiation age was 16 years. Compared with argileh smokers, significantly greater proportions of nonsmokers had positive attitudes about argileh banning and more accurate knowledge about argileh. Argileh smoking among Lebanese young is on the rise. Students demonstrated partial knowledge and moderate to favorable attitudes concerning argileh smoking. Possible public health interventions are discussed in light of the social and cultural context of argileh use to neutralize this emerging global public health threat.