Background: Scabies is a contagious skin disease caused by Sarcoptes scabiei var. hominis and remains a public health problem, particularly in densely populated settings with inadequate environmental sanitation and poor personal hygiene. Islamic boarding schools may represent high-risk environments because students live in close contact and often share facilities and personal belongings. Objective: This study aimed to determine the relationship between environmental sanitation conditions, personal hygiene, and scabies symptoms among students at Darul Hikam Islamic Boarding School, Rimbo Ulu District, Tebo Regency. Methods: This observational study used a quantitative approach with a cross-sectional design. The study was conducted in April 2021 at Darul Hikam Islamic Boarding School. The population consisted of 400 students, and 63 respondents were selected using proportionate stratified random sampling. Data were analyzed using the chi-square test, with a significance level of p < 0.05. Results: A total of 45 respondents (71.4%) experienced scabies symptoms. No significant association was found between clean water supply facilities and scabies symptoms (p = 0.571). Significant associations were found between occupancy density (p = 0.008; PR = 8.500; 95% CI: 1.212–59.599), ventilation area (p < 0.001; PR = 0.057; 95% CI: 0.008–0.403), skin hygiene (p = 0.038; PR = 0.400; 95% CI: 0.190–0.842), towel hygiene (p = 0.036; PR = 0.392; 95% CI: 0.176–0.871), and mattress and bed linen hygiene (p = 0.049; PR = 0.400; 95% CI: 0.172–0.931) with scabies symptoms. Conclusion: Occupancy density, ventilation area, skin hygiene, towel hygiene, and mattress and bed linen hygiene were significantly associated with scabies symptoms among students at Darul Hikam Islamic Boarding School. Clean water supply facilities were not significantly associated with scabies symptoms. Improvements in dormitory environmental conditions and personal hygiene practices are needed to support scabies prevention and control.