Objective <p>This study examined the relationship between sweet consumption and academic performance among medical university students in Palestine. A cross-sectional survey was conducted among full-time students selected via stratified sampling. Data on academic performance (self-reported GPA), sweet consumption frequency, and potential confounders (demographics, BMI, parental education, income, breakfast consumption, physical activity, and mental health via the Strengths and Difficulties Questionnaire) were collected using structured questionnaires. Multiple linear regression models were used to assess associations.</p> Results <p>Of 355 invited students, 220 completed the survey (response rate: 62%). Nearly half (48.2%) reported consuming sweets daily or more. Frequent sweet consumption was significantly associated with lower GPA in both crude and fully adjusted models (β = − 0.15; 95% CI: − 0.29, − 0.01; <i>p</i> = 0.039). Low physical activity (β = − 0.22; <i>p</i> = 0.008) and abnormal mental health scores (β = − 0.31; <i>p</i> = 0.004) were also independently linked to poorer academic performance. Frequent sweet intake is independently associated with reduced academic achievement among university students, even after adjusting for lifestyle and mental health factors. Promoting healthy eating and mental well-being may support academic success in this population.</p> Clinical trial number <p>Not applicable.</p>