Fitness to Practise (FtP) procedures play a critical role in maintaining professional and ethical standards across regulated and accredited disciplines delivered in higher education settings. Despite their importance, there is limited research examining this area of university practice. This study addresses an important gap in the literature concerning how universities in the UK operationalise and enact FtP procedures, by exploring the range and types of courses subject to FtP procedures, the reason for referral, and the frequency and outcomes of such processes. Using data obtained through freedom of information requests, five key findings emerged: (1) the enactment of student FtP procedures is primarily concentrated within health and allied professions; (2) the most common reasons for referrals were unprofessional or inappropriate behaviour; (3) a minority of universities recorded very high volumes of referrals, suggesting variability across the sector; (4) referral outcomes were graduated, ranging from informal action plans and supportive adjustments through to withdrawal from programmes although the latter was rare and (5) the data held was often incomplete, recorded in ways that were challenging to interpret and not retained centrally. Implications for practice are considered, as are future directions for research in this underexplored area of higher education.