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Objectives To evaluate the satisfaction and self-confidence levels among midwifery students in clinical training programmes at Palestinian universities and to identify associated factors.Design A descriptive, cross-sectional study.Setting Clinical training programmes at five universities across the West Bank, Palestine, during the second semester of the 2023—2024 academic year.Participants A convenience sample of 116 final-year (third- and fourth-year) midwifery students actively engaged in clinical training.Primary and secondary outcome measures The primary outcomes were satisfaction and self-confidence, measured using validated scales adapted from the National League for Nursing. Demographic factors (university, academic year, training area, gender) were analysed as secondary measures influencing the primary outcomes.Results Students reported moderate satisfaction (mean=3.38±0.75, 95% CI: 3.25 to 3.51) and high self-confidence (mean=3.61±0.73, 95% CI: 3.49 to 3.73). A strong positive correlation was found between satisfaction and training area (r=0.693, p<0.001), and between self-confidence and timing of clinical training (r=0.45, p=0.01). Students from the southern West Bank expressed the highest satisfaction (mean=3.55, p<0.001). Multiple linear regression identified academic year (B=0.9096, p=0.029 for satisfaction; B=0.9239, p=0.028 for self-confidence) and gender (B=−1.7776, p=0.035 for satisfaction; B=−1.8062, p=0.033 for self-confidence) as significant predictors of both outcomes, with male students reporting lower levels.Conclusions Geographical disparities and gender significantly influence midwifery students’ clinical training experiences in Palestine. These findings highlight the need for equitable distribution of training resources, the implementation of gender-sensitive mentorship programmes and tailored support for students in advanced academic years to improve educational outcomes and build a capable healthcare workforce.