The present study was designed to evaluate the health effects of dietary nanozinc prepared by two methods: conventional chemical method and green method. The parameters evaluated were the extent of bioaccumulation, antioxidant status, histological, immunological changes and DNA damage in Nile tilapia fed nanozinc feed. Zinc oxide nanoparticles were first prepared by green and chemical methods. Before feed preparation, the in vitro antioxidant activity and antibacterial activity of both types of nanoparticle solutions were tested and the results revealed enhanced activities in green synthesized ZnO NP solution. After the acclimatization period, 420 Nile tilapias were distributed randomly into 21 glass tanks with 20 fish per tank in triplicates. Fish were fed control diet without any ZnO NP and (i) GT1—green synthesized ZnO NP diet at 100 mg/kg, (ii) CT1—chemically synthesized ZnO NP diet at 100 mg/kg, (iii) GT2—green synthesized ZnO NP diet at 200 mg/kg, (iv) CT2—chemically synthesized ZnO NP diet at 200 mg/kg, (v) GT3—green synthesized ZnO NP diet at 400 mg/kg and (vi) CT3—chemically synthesized ZnO NP diet at 400 mg/kg for 60 days. After 60 days, gill and liver samples were collected for analysing oxidative stress, histopathological alterations and bioaccumulation of zinc, whereas serum samples were collected for evaluating immune response. The results revealed that the GT3 diet significantly (P < 0.05) enhanced the level of antioxidant enzymes (CAT, SOD, GPx, GR and GSH) than dietary nanozinc prepared by the chemical method. Similarly, the innate immunological parameters were significantly (P < 0.05) augmented in fish fed GT3 diet. Comparative histological study of liver and gill tissues revealed normal architecture in the tissues of fish fed green synthesized NP–enriched feed, whereas the tissues of fish fed chemically synthesized NP feed exhibited histological alterations. Bioaccumulation of zinc was more in the liver followed by the muscle and least in the gills and DNA damage was more evident in fish fed chemically synthesized ZnO NP–enriched feed. In conclusion, the results suggest that the inclusion of 400 mg/kg GT3 diet in fish diet enhanced the level of antioxidant enzymes, boosted immune response and did not cause histological damage to organs, and therefore, GT3 nanofeed can be recommended for fish health improvement.