Objective: To examine fruit and vegetable intake and self-efficacy among U.S. college students in a rural, Southern location. Participants: Undergraduate students (n = 1503) enrolled in a university-wide health class at one large public institution during the spring 2017 semester. Methods: Cross-sectional survey data were collected online and analyzed using independent samples t test, one-way ANOVA, and regression. Results: On average, participants did not meet fruit or vegetable intake recommendations. Mean self-efficacy scores were 17.2 (SD = 3.4) and 16.42 (SD = 3.7) for fruit and vegetables, respectively, with statistically significant differences observed by sex and race (p < 0.05). Hierarchical multiple regression results indicated self-efficacy explained 20.9% (fruit) and 29.3% (vegetables) of the variance in consumption. Similar patterns were found for meeting daily fruit and vegetable intake recommendations. Conclusions: Health campaigns are needed to address sex and racial disparities in college student fruit and vegetable intake and self-efficacy.