We aimed to study supplement use in relation to dietary intake among pregnant women in Sweden, and adherence to the Nordic Nutrition Recommendations among supplement and non-supplement users. Pregnant women were recruited at registration to antenatal care in 2013-2014. In third trimester, supplement use was collected using a questionnaire, and dietary intake was collected using a food frequency questionnaire. The majority (64%) of the 1044 women reported use of one or more supplements. Among all, 0-23% reported dietary intakes above recommended intake (RI) of vitamin D, folate, iron, and selenium. Median dietary intakes of thiamine (1.4 vs 1.3 mg p=0.013), phosphorus (1482 vs 1440 mg p=0.007), folate (327 vs 316 µg p=0.02), iron (12 vs 11.5 mg p=0.009), magnesium (361 vs 346 mg p<0.001), and zinc (10.7 vs 10.4 mg p=0.01) were higher among supplement users compared to non-users. Larger proportions of supplement users than non-users adhered to RI of dietary intakes of thiamine (42% vs 35% p=0.04) and magnesium (75% vs 69% p=0.05). Among non-users, a minority had dietary intakes above RI for vitamin D (6%), folate (10%), and iron (21%). The majority (75-100%) of supplement users had total intakes above RI for most nutrients. In conclusion, supplement use contributed substantially to reaching RI for vitamin D, folate, and iron. Supplement users had a higher dietary intake of several nutrients than non-users. This highlights that non-supplement users are at risk of inadequate nutrient intakes during pregnancy, suggesting a need for heightened awareness of nutritional adequacy for pregnant women.