This study examined the association between students' approaches to learning and stages of reflective thinking. The revised version of the Study Process Questionnaire was used to measure deep and surface approaches to learning and the Reflection Questionnaire was used to distinguish four stages of reflective and nonreflective thinking. Both questionnaires were completed by 402 undergraduates from all years of study from a health science faculty in a university in Hong Kong. Confirmatory factor analysis was used to test possible associations. The results showed that only the habitual action scale correlated significantly to surface approach to learning. Understanding, reflection and critical reflection correlated with deep approach but had no correlation to surface approach. Understanding, reflection and critical reflection correspond to the use of a deep approach with increasing levels of meaningful personal assimilation. These findings provide evidence of close association between approaches to learning and stages of reflection upon practice. The results also provide evidence for the convergent validity of both questionnaires.