Objective: To describe the emergence of the nutrition transition, and associated morbidity shifts, in the Islamic Republic of Iran. Design: Review and analysis of secondary data relating to the socio-political and nutritional context, demographic trends, food utilisation and consumption patterns, obesity, and diet-related morbidity. Results and conclusions: The nutrition transition in Iran is occurring rapidly, secondary to the rapid change in fertility and mortality patterns and to urbanisation. The transition is occurring against the backdrop of lack of sustained economic growth. There is considerable imbalance in food consumption with low nutrient density characterising diets at all income levels, over-consumption evident among more than a third of households, and food insecurity among 20% of the population. Obesity is an emerging problem, particularly in urban areas and for women, and both diabetes and other risk factors for heart disease are becoming significant problems.