To investigate the cognition on prototype category of five elements among college students, and to provide education bases for the five-elements theory of Chinese medicine. Methods: By using “Category based on the theory of five elements prototype questionnaire”, 166 college students in Beijing were investigated. The data were analyzed by percentage frequency distribution, descriptive statistics and independent-samples tests with SPSS 19.0. Results: The cognition of wood, land and water prototype fell on middle level (x->5), but gold and fire prototype fell on low level (x-<5). Compared between undergraduate and graduate students, there was significant difference in the mean value of cognition of wood, land, gold and water prototype (P<0.01), mutual generation and mutual restriction of five elements (P<0.01), and reverse restriction of five elements (P<0.05). Conclusion: The cognition of five elements of college students was at middle level. They have the good perception of wood, land and water elements, but fuzzy in gold and fire elements. This generally means the concept of gold and fire elements is vague, or has multiple meanings, which require further elaboration or specification to understand their applicability.