In his freshman season at Xavier, West was named to the Atlantic 10 All-Rookie Team after leading the A-10 in rebounding (9.1) and finishing fourth on the Musketeers in scoring (11.7).

In his sophomore season, West led Xavier in scoring (17.8 ppg), rebounding (10.9 RPG, tops in A-10 and fourth nationally), and blocks (2.1 BPG). He recorded five 20-point, 20-rebound games throughout the 2000–01 season as he earned his first A-10 Player of the Year award.

In his junior season, West was named the A-10 Player of the Year and the league’s Defensive Player of the Year, while also winning A-10 Tournament MVP honors. He averaged 9.8 rebounds (26th in the nation) and 2.5 blocks (22nd in the nation) per game and recorded the first triple-double in school history with 15 points, 10 rebounds, and 10 assists against Long Island University.

In his senior season, West garnered two of the five major college basketball Player of the Year honors, being named AP National Player of the Year and National Player of the Year by the United States Basketball Writers Association. He became the first three-time Atlantic 10 Player of the Year and was named first-team All-America by the Associated Press in 2002–03. In addition, he became just the third player in Xavier history to surpass 2,000 points and only the second to eclipse 2,000 points and 1,000 rebounds, joining Tyrone Hill.

In October 2007, Sports Illustrated released Sports Illustrated: The Basketball Book, which featured West on its NCAA All-Decade Team for the decade beginning in 2000. He was joined by Connecticut’s Emeka Okafor and three Duke players, Jay Williams, J. J. Redick and Shane Battier.