Abstract: Dietary trends have been found to be related with metabolic syndrome in various studies. To identify dietary patterns and study associations between the dietary patterns of subjects with high and low risk of metabolic syndrome in a Karachi based community. A group of 871 men and women were selected randomly from 532 households. Data about consumption of specific foods was available for 867 adults. Participants completed a health and lifestyle questionnaire and 363 subjects provided fasting blood samples for glucose and lipids. Dietary intake was assessed by a questionnaire to identify consumption of 33 specific food items and the dietary patterns categorized into 6 food groups was assessed by cluster analysis. Five dietary patterns were identified through cluster analysis. Cluster 1 had the lowest proportion of persons with metabolic syndrome i.e. 42.7% while cluster 2 had the highest percentage of metabolic syndrome subjects (56.3%) (p = 0.09). Consumption of fat and caloric dense foods was significantly higher among highest risk group (cluster 2) compared to lowest risk group (cluster 1) (p = 0.0001). The consumption of food groups containing fruit, milk and meat was also more than twice in high risk compared to low risk group (p = 0.0001). Even within the same population there are marked differences in dietary patterns and these apparently contribute to the risk of developing metabolic syndrome. Dietary pattern studies will help elucidate links between diet and disease and contribute to developing healthy eating guidelines.