In an increasingly digital world, generative artificial intelligence (GenAI) tools are transforming higher education by offering personalized learning experiences and enhancing skill development. This chapter presents findings from an international survey of 2,387 students across 20 countries and a China-specific survey of 21,092 students, exploring the adoption, perceptions, and challenges of GenAI tools in higher education. Key findings reveal significant variations in GenAI usage and attitudes across gender, age, discipline, university tier, and region. Male students and those in engineering and technology fields reported higher usage and confidence, whereas their female, younger, and arts and humanities counterparts exhibited lower engagement and greater skepticism.In China, students from Double First-Class universities and economically developed regions demonstrated higher usage but greater caution towards GenAI-generated content. The study highlights the need for tailored strategies to integrate GenAI tools ethically and effectively, addressing disparities in access, training, and trust. These insights provide a foundation for future research, policy development, and the responsible implementation of GenAI in global higher education.