Background: Body dysmorphic disorder (BDD) is a mental disorder that disrupts young adults' self-image and might damage their lives. BDD includes preoccupation with one or more perceived physical flaws that are not visible to others, along with repetitive behaviors or mental acts in response to appearance worries. Objective(s): The study aimed to estimate the prevalence of body dysmorphic symptoms among university students in Alexandria, Egypt, and to identify some of its determinants. Methods: A cross sectional study was conducted among 636 randomly selected first year university students in Alexandria. The data was collected using a predesigned structured self-administered questionnaire along with the Arabic version of the Body Dysmorphic Disorder Questionnaire (BDDQ). Results: The prevalence of BDD symptoms was estimated to be 5.3% among Alexandria University students. BDD symptoms were significantly more common in females than males (8.5% Vs. 2.2%, p < 0.001). The most common areas of concern were skin (36.6%) and belly size (36.2%). The logistic regression revealed that four variables were proved to be significant predictors of BDD symptoms; female gender (OR=3.011, 95% CI=1.220-7.436), time spent on social media (OR=2.926, 95% CI=1.337 - 6.403), history of exposure to bullying (OR=6.202, 95% CI=1.994 - 19.291), and not asking for support when needed (OR=3.327, 95% CI= 1.296 - 8.542). Conclusion: Symptoms of BDD are relatively common among university students in Alexandria and are more common among females. Preventive mental health services should be supported on the universal level as well as in schools and universities.