AIM: To investigate the associations between fruit and vegetable consumption and risk of asthenopia among Chinese college students. METHODS: A total of 1022 students were selected from five universities by a multi-stage stratified cluster sampling method. They were surveyed via a self-administered questionnaire including socio-demographic features, dietary and lifestyle habits, eye-related symptoms, eye care habits and history of diseases. Ascertainment of asthenopia was based on participants' subjectively reported symptoms. The associations between fruit and vegetable intake with asthenopia risk were assessed using multivariate logistic regression analysis. RESULTS: There were no significant associations between total fruit and vegetable, total vegetable, or fruit and the risk of asthenopia. Higher intake of dark-green leafy vegetable was likely to be inversely associated with asthenopia risk [odd ratio (OR): 0.60; 95%CI: 0.37-0.97; Ptrend=0.21] after controlling for nondietary and dietary risk factors. Stratified analysis showed that the inverse association between dark-green leafy vegetable intake and asthenopia risk was limited to participants with suboptimal eyesight (OR: 0.45; 95%CI: 0.25-0.82; Ptrend=0.05), wearing glasses (OR: 0.35; 95%CI: 0.17-0.72; Ptrend=0.03) or using computer ≥3h/d (OR: 0.48; 95%CI: 0.25-0.93; Ptrend=0.08). CONCLUSION: A higher consumption of dark-green leafy vegetable is associated with a lower asthenopia risk among college students with suboptimal eyesight and poor eye care habits.