Food environments in Africa are changing rapidly, with modern retailers—such as supermarkets, hypermarkets, and fast-food restaurants—gaining in importance. Changing food environments can influence consumers’ food choices and dietary patterns. Recent research has suggested that the growth of supermarkets leads to more consumption of processed foods, less healthy diets, and rising obesity. However, relatively little is known about what type of consumers actually use modern supermarkets and to what extent. Moreover, focusing only on supermarkets may be misleading, as most consumers obtain their food from various modern and traditional retailers. We add to the literature by examining relationships between consumers’ socioeconomic status, use of different modern and traditional retailers, and dietary patterns. The analysis uses household survey data from urban Zambia. Results show that two-thirds of the households use modern and traditional retailers simultaneously, but that richer households are more likely than poorer ones to use supermarkets and hypermarkets. Use of modern retailers is positively associated with higher consumption of ultra-processed foods, after also controlling for income and other socioeconomic factors. However, the use of traditional stores and kiosks is also positively associated with the consumption of ultra-processed foods, suggesting that modern retailers are not the only drivers of dietary transitions.