Introduction: Cardiovascular disease (CVD), hypertension (HTN) and chronic kidney disease (CKD) are chronic conditions of recent decades, and dietary intakes play an important role in their prevention. The purpose of this study was to examine the association between dietary fat pattern and incidence of these conditions. Materials and Methods: Participants of the third phase (2006-2008) of the Tehran Lipid and Glucose Study (TLGS), who met the inclusion criteria for each of the risk factors were selected. Finally, 2369 participants for CVD, 1878 persons for HTN and 1780 persons for CKD were enrolled and followed up to the fifth phase of TLGS. Dietary fat patterns in the third phase determined by principal component analysis (PCA) and the association between each of three patterns and CVD and HTN were assessed by Cox proportional hazard regression models, and the association between fat patterns and CKD incidence were assessed by linear regression models. Results: During 6 years of follow-up, the incidence of CVD, HTN and CKD in population studied was 3.3, 15.5 and 17.9%, respectively. Based on PCA, three separate dietary fat patterns were obtained for each of cardio-metabolic risk factors. The first pattern had high loads of cholesterol, SFA, Oleic acid, Linolenic acid and Linoleic acid; the second had high loads of EPA and DHA and third pattern had a high load of trans fatty acids. After adjustment for potential confounders, there was no significant association between odds ratio (95% confidence intervals) of CVD, HTN or CKD incidence and dietary fat patterns. Conclusion: In this study, no significant association was found between dietary fat patterns and the incidence of cardio-metabolic risk factors incidence. Further prospective studies are needed to investigate and confirm the effects of dietary fat on the development of chronic diseases.