Objective: To explore the relationship between nutritional literacy and physical health of rural primary school students under different nutritional meal provision modes, so as to provide scientific evidence for optimizing the Nutrition Improvement Program for Rural Compulsory Education Students. Methods: From September 21 to 30, 2022, a total of 1 595 rural primary school students were selected from Ruyang County, Luoyang City, by using stratified cluster random sampling. Information on students nutrition literacy was collected through a questionnaire survey and matched with their physical health monitoring data. Multiple linear regression model and linear probability model were conducted to analyze the relationships among nutrition literacy, nutritional meal provision modes (nutritious school lunch and recess snacks) and students physical health. Results: The nutrition literacy score of rural primary school students was (68.21±11.09), with girls scoring higher than boys (69.45±9.79, 66.96± 12.07 ), and the difference was of statistical significance ( t =4.52, P <0.01). Results of the linear probability model showed that primary school students with higher nutrition literacy had a greater probability of achieving excellent scores in physical fitness tests ( β =0.008, P <0.01). Further analysis by nutritional meal provision modes indicated that under the school nutrition lunch mode, primary school students with higher nutrition literacy were still more likely to attain excellent physical fitness test results ( β =0.008, P <0.05). Conclusions Nutrition literacy level is associated with physical health status among rural primary school students. Nutrition literacy education should be strengthened according to the characteristics of nutritional meal provision modes, so as to improve the effectiveness of the nutrition improvement program.