Purpose: This study aims to analyse student and teaching staff views on how higher education (HE) can contribute to sustainable development, and to provide examples of how a medical university has adopted the sustainable development goals (SDGs) as part of its institutional strategies and practises. Design/methodology/approach: The study is based on participant views from a conference, which aimed to identify actions needed for HE to contribute to the SDGs. More than 500 students, teachers and academic leaders participated at workshops to discuss and reflect on the role of higher education institutions (HEIs) in sustainable development. The discussion key points were recorded on flipcharts, and the analysis builds on all written statements from the nine workshops. Based on the findings from the workshop, steering documents and activities of a medical university were identified as examples of implementation. Findings: Two overarching interdependent themes were identified and indicated a need to rethink the role not only of HE per se but also that of HEIs at large, to meet the challenges of sustainable development. The study also provides an example of how such organizational change can be practically implemented at a medical university, through the establishment of overarching institutional strategies, funding opportunities and external collaborations. Practical implications: The findings reflect a “bottom-up” call from students and educational staff for HEIs to step up and contribute to systems change – both through a change in pedagogies, as well as through an institution-wide approach and a shift in the role of HEIs in society. Originality/value: The study is unique in providing an exemplar of the implementation of sustainable development in HE at a specific medical university.