Objective The purpose of this study was to investigate the current status of physical fitness and the health literacy and the differences among college students in Macau. In addition, the correlation between fitness and health literacy. Methodology The participants were 156 college students in Macau. Background information, (gender, age and accommodation etc.) Health Literacy and fitness test conducted (body composition, cardiovascular capacity, muscular strength, muscular endurance and flexibility) and data were collected. The European Health Literacy Questionnaire (HLS-EU-Q) was used, and Cronbach’s alpha for each aspect were 0.87, 0.89 and 0.93, respectively and the scale was 0.95. SPSS 20.0 was used to analyse initial retrieved data. Descriptive statistics, independent sample t-test, one-way ANOVA and correlation analysis. Results & Discussion Firstly, female college students were significantly higher than male college students on body composition (t=-10.70) and flexibility (t=-2.75). Students of FST were significantly higher than the students of FED on height (F=3.81) and muscular strength (F=3.28). They were also significantly better than the students in FAH and FSS on muscular strength (F=3.91). In addition, they had more muscle mass than the students in FAH (F=3.26). Students live in dorms of college were significantly higher than non-resident students on the results of muscular strength (t=-2.14) and cardiovascular capacity (t=-2.11). Secondly, the overall scores of health literacy for Macau college students were above the average and with no significant difference on different factors. Thirdly, Muscle mass had the low positive correlations with disease prevention (r=.16), health promotion (r=.19) and overall health literacy (r=.18); results of hand grip had the low positive correlations with disease prevention (r=.16） and overall health literacy（r=.17）; results of standing long jump and one-minute sit-ups had the low positive correlations with health promotion （r=.23；r=.22） and overall health literacy（r=.19；r=.17）. Conclusion The overall scores of health literacy for Macau college students were above the average, but there were no significant difference between different factors. In addition, part of the physical fitness component had the low positive correlations with health literacy. This study suggested to expand the research scope and cover each colleges of Macau in future studies.