Adolescence is a critical time in life when health behavior, including eating habits becomes established. Nutrition literacy is the ability of individuals to acquire nutritional knowledge and skills required for making proper nutrition decisions. Mediterranean Diet (MD) is a nutritional strategy that encompasses the entire lifestyle, as it is complemented with proper sleep and physical activity. Despite the MD's numerous benefits adolescents are moving away from it affected by the phenomenon of nutrition transition and westernization of diet, because of globalization and urbanization. Assessing adolescents' nutrition literacy can assist policymakers in developing effective health-promoting initiatives, improving the nutritional status of adolescents and enhancing their health and quality of life.The objective was to assess nutrition literacy status among early adolescents, their adherence to the Mediterranean diet (MD)and lifestyle. A cross-sectional design performed among a sample of adolescents (350) in Giza,Egypt. Nutrition literacy was assessed using the 'Adolescent Nutrition Literacy Scale'. Dietary intake was evaluated through a 24-hour food recall, while adherence to the Mediterranean Diet (MD) was assessed using the 'Mediterranean Diet Quality Index' among the adolescents and International Physical Activity Questionnaire (IPAQ) was used to assess physical activity. The studied adolescents showed poor level of nutrition literacy scoring 39.05 ± 19.87, the majority of participants (88%) didn't receive nutrition education at school. The mean nutrition literacy score is significantly higher among adolescents who were highly adherent to Mediterranean diet (scored >8 in KIDMED index score), with high level of practicing physical activity, practicing more healthy eating habits, and reported less screen time exposure. In conclusion the study indicated suboptimal nutrition literacy among adolescents with significant positive correlation to Mediterranean diet adherence and engagement in healthy lifestyle behaviors such as maintaining healthy eating habits, performing physical activity and reducing screen time exposure.