Background: Role of dietary modifications on the treatment and management of diabetes and complications was shown by many researchers. This study was designed to examine the association of major dietary patterns with diabetes-related cardio-metabolic risk factors in Iranian diabetes. Methods: Totally, 525 type 2 diabetic subjects with mean age 55 ± 10 yr were included in this cross-sectional study in 2014 that followed for at least two years by the Diabetes and Metabolic disease Clinic of Tehran University of Medical Sciences, Tehran, Iran. Blood samples were collected after 12 h fasting for glycemic and lipid profiles. Information on the general characteristics, anthropometric, blood pressure measurements and physical activity level was collected. Dietary data were obtained by a validated food frequency questionnaire. Dietary patterns were obtained factor analysis (principal component analysis). Results: Three major dietary patterns retained through principal component analysis: Western like (high in sweets, fast foods, carbonated drinks, red meat, mayonnaise, nuts, refined grains, potato and visceral meat), Asian like (high in vegetables, low-fat dairy, fish, poultry and egg), and Traditional like (high in high fat dairy, oils, whole grains, vegetables and fruits). Western like dietary pattern was positively associated with fasting serum glucose ( P =0.05), total cholesterol ( P =0.005) and low-density lipoprotein cholesterol ( P =0.008). After extensive adjustment for potential confounders, the association of serum total cholesterol and Western like dietary pattern remained significant ( P =0.03). Conclusion: Modifications in dietary pattern, especially in those who have a Western dietary pattern, may be effective in preventing or delaying diabetes-associated cardio metabolic complications. Keyword: Diet, Principal component analysis, Diabetes mellitus type 2, Risk factors