OBJECTIVE: The present study aimed to evaluate the independent associations between serum leptin concentration and dietary patterns in a Chinese population. DESIGN: A cross-sectional study. SETTING: Data obtained from the 2006 wave of the China Health and Nutrition Survey in Jiangsu Province, China. SUBJECTS: The sample contained 1061 Chinese adults (488 men and 573 women). BMI was calculated as a parameter of obesity. Factor analysis was used to derive dietary patterns. ANCOVA was performed to assess the associations between serum leptin concentration and the dietary patterns. RESULTS: Four dietary patterns were derived: Western, High-wheat, Traditional and Hedonic. The Western pattern (rich in meat, milk and cake) was significantly associated with a higher level of serum leptin in men and women, both in an unadjusted model (both P for trend < 0·001) and after adjusting for sex, age, income, total energy intake, physical activity, smoking status and BMI (P for trend = 0·007 for men and P for trend < 0·001 for women). The other three dietary patterns were not significantly associated with serum leptin after adjustment. Sensitivity analysis showed there was an interaction between age and the Western pattern in relation to leptin level. An interaction also existed between current smoking status and the Western pattern. CONCLUSIONS: Serum leptin concentration was positively associated with the Western dietary pattern in a Chinese population independent of BMI, energy intake and other factors.