Objective This study explored associations between narcissistic grandiosity (including its component traits) and reported risky health behaviors in college students. Participants: College men and women (N = 122) participated between December 2015 and January 2016. Methods: Participants completed self-report measures of grandiosity, alcohol consumption, number of sex partners, and condom use. Results: Grandiosity was positively associated with alcohol consumption. Gender interacted with grandiose traits, driving associations with reported sexual behaviors. College men high in entitlement/exploitativeness reported more sex partners. Grandiose exhibitionism was associated with condom use among women but not men, such that college women higher in grandiose exhibitionism were more likely to report not using a condom with their most recent partner. Conclusions: Grandiosity (and grandiose traits) may influence health behavior and/or the reporting of health behavior in college students, but associations may differ for men and women.