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OBJECTIVE To compare and predict kinesiophobia and fear avoidance beliefs between athletes with gastrocnemius myofascial pain syndrome (MPS) and healthy athletes. DESIGN Case-control. SETTING Outpatient clinic. SUBJECTS Fifty athletes were divided into athletes with chronic gastrocnemius MPS (N = 25) and healthy athletes (N = 25). METHODS Kinesiophobia symptoms total and domain scores (harm and activity avoidance) and levels were determined by the Tampa Scale of Kinesiophobia (TSK-11). Fear avoidance beliefs total and domain scores (physical and working activities) were measured by the Fear Avoidance Beliefs Questionnaire (FABQ). RESULTS Significant differences (P < 0.05) with a large effect size (d = 0.81-4.22) were found between both groups, with greater kinesiophobia symptom scores for the TSK-11 activity avoidance domain and total scores, and greater fear avoidance beliefs scores for the FABQ physical and working activities domains and total scores of athletes with gastrocnemius MPS with respect to healthy athletes. TSK-11 total score showed a prediction model (R2 = 0.256) based on the FABQ total score. The FABQ total score showed a prediction model (R2 = 0.741) based on gastrocnemius MPS presence (R2 = 0.665), levels of kinesiophobia (R2 = 0.052), and height (R2 = 0.025). CONCLUSIONS Greater kinesiophobia levels, greater total and activity avoidance domain scores (but not for the harm domain), and greater fear avoidance beliefs total and domain scores (work and physical activity) were shown for athletes with gastrocnemius MPS vs healthy athletes. Higher kinesiophobia symptoms were predicted by greater fear avoidance beliefs in athletes. Greater fear avoidance beliefs were predicted by the presence of gastrocnemius MPS, higher levels of kinesiophobia, and lower height in athletes.