Objectives <p>Virtual reality–based digital mindfulness tools (VR-DMTs) effectively reduce depressive symptoms and anxiety in college students, enhancing both physical and mental health. However, their preferences and acceptance among Chinese college students are not well understood.</p> Methods <p>This study used the analytic hierarchy process method to develop a design preference framework, which was refined through a questionnaire completed by 12 experts to assess the importance of the first-level indicators. A subsequent survey of 154 college students was then conducted to assess their preferences for the second-level indicators within the framework. Furthermore, based on the Theory of Planned Behavior and integrating both experiential and technical factors, the survey also examined factors relating to VR-DMTs acceptance.</p> Results <p>The results revealed that virtual environments and objects are the two main interactive elements that students prefer in VR-DMTs. Students preferred visual and auditory guidance, particularly when combined with environmental feedback to enhance immersion, and favored mixed inputs over passive ones. Students also showed interest in interactive mindfulness training with gamification and narrative elements. Regarding the acceptance, this study revealed that the model explains 44.1% of the variance in students’ behavioral intentions to use VR-DMTs. Attitude and subjective norm were significantly related to behavioral intentions. Perceived behavioral control was indirectly related to intentions via attitude. Presence was also indirectly related to intentions, with educational and escapist experiences enhancing presence.</p> Conclusions <p>These findings expand the understanding of digital mindfulness and provide valuable insights for VR-DMTs development.</p>