Objectives:Premenstrual syndrome (PMS) is a common cyclic psychological and somatic disorder which reduces women’s quality of life. Evidence regarding the association between dietary patterns (DPs) and PMS is rare. The study aimed to determine the relationship between dietary patterns and PMS.Design:The case-control study was conducted among women with confirmed PMS and healthy individuals recruited from healthcare centres.Setting:Dietary data were collected using a validated semi-quantitative food frequency questionnaire and DPs were derived using principal component analysis. The association between DPs and likelihood of PMS was determined using logistic regression.Participants:In total, 225 women with PMS and 334 healthy participants aged 20–46 years took part in the study.Results:Three major DPs were identified: (i) ‘western DP’ characterized by high intake of fast foods, soft drink, and processed meats; (ii) ‘traditional DP’ in which eggs, tomato sauce, fruits, and red meat were highly loaded; and (iii) ‘healthy DP’ high in dried fruits, condiments and nuts. After taking all possible confounders into account, individuals in the highest tertile of the western DP were more likely to experience PMS (odds ratio (OR) = 1·49; 95 % CI: 1·01, 3·52), P < 0·001), whilst both healthy and traditional DP was inversely associated with the syndrome (OR = 0·31; 95 % CI: 0·17, 0·72, P = 0·02; OR = 0·33; 95 % CI: 0·14, 0·77, P = 0·01, respectively).Conclusion:The western dietary patterns were positively associated with PMS, whilst the healthy and traditional dietary patterns were inversely associated with it. Further longitudinal studies are required to confirm our findings.