Purpose This study aims to evaluate level of fear and the tendency toward orthorexia nervosa (ON) during the COVID-19 pandemic in the university students receiving health education. Design/methodology/approach A total of 765 students, consisting of 626 females (81.8%) and 139 males (18.2%) were included in the study. The demographic characteristics, anthropometric measurements, Eating Attitude Test-26 (EAT-26), Fear of COVID-19 Scale (FCV-19S) and the tendency toward ON were assessed using an online questionnaire. Findings The FCV-19S scores differed according to gender and were higher in the female students (P < 0.001). In students with a high EAT-26 score, the tendency toward ON was higher (P < 0.001). According to estimated regression models, a unit increase of the FCV-19S scores led to a decrease of 0.10 points in the Orthorexia Nervosa Evaluation Scale-11 (ORTO-11) scores. It was determined that students with high FCV-19S scores had a tendency toward ON and increased EAT-26 scores (P < 0.001 and P = 0.004, respectively). There was a weak negative correlation between the FCV-19S score and the ORTO-11 score (P < 0.001) and a weak positive correlation between the FCV-19S score and the EAT-26 score (P = 0.001). Originality In this cross-sectional study, it was determined that the fear of COVID-19 was related to an increase in the tendency toward ON and eating attitude in students receiving health education. Because of the fear and ON tendencies of students due to the COVID-19 pandemic, it would be beneficial to provide education on adequate and balanced nutrition during this period.