Background <p>Compulsive shopping, a dysfunctional behavior with psychological, financial, and social consequences, is a growing concern, especially among students. Given the potential influence of family functioning and fashion orientation on this behavior, the present study aims to examine the association between compulsive shopping behavior, family functioning, and fashion orientation among female students.</p> Methods <p>This descriptive cross-sectional correlational study, conducted in 2024, involved 314 female students from Hamadan University of Medical Sciences, selected through multi-stage sampling after meeting the inclusion criteria. Data were collected using a General Characteristics questionnaire, the Faber and O’Guinn Compulsive Buying Scale, the Family Assessment Device (FAD), and the Weber Fashion Interest Scale. Data analysis was performed with SPSS (version 24), including Kolmogorov-Smirnov tests, Pearson correlation, independent t-tests, one-way ANOVA, and linear regression.</p> Results <p>The mean scores for compulsive shopping behavior, fashion orientation, and family functioning were 12.12 (SD = 6.52), 33.54 (SD = 17.29), and 23.23 (SD = 20.36), respectively. A significant positive correlation was found between compulsive shopping and fashion orientation (<i>r</i> = 0.510, <i>p</i> &lt; 0.001), explaining 10.4% of the variance. A significant negative correlation was observed between compulsive shopping and family functioning (<i>r</i> = -0.323, <i>p</i> &lt; 0.001), accounting for 22.4% of the variance. Fashion orientation also showed a negative correlation with family functioning (<i>r</i> = -0.207, <i>p</i> &lt; 0.001), predicting 8.2% of the variance.</p> Conclusions <p>This study shows a significant association between compulsive shopping behavior, fashion orientation, and family functioning. Strengthening family support and implementing educational programs on consumption management and the consequences of these behaviors are recommended.</p>