Introduction: To identify a dietary pattern predictive of visceral adiposity index (VAI), using reduced rank regression, and to examine its associations with cardiometabolic risks in the PCOS women. Materials and Methods: This case-control study was conducted on 53 PCOS women and 167 age-matched healthy women from the population of Tehran Lipid and Glucose Study. Dietary intakes were collected using a semi-quantitative food frequency questionnaire. The associations of dietary pattern with cardiometabolic risks were investigated by Pearson's correlation and linear regression. Results: In this study, a positively correlated VAI dietary pattern, characterized by high consumption of fried vegetables, vegetable oils (except for olive oil), fast foods and low cons­umption of dairy, and cruciferous vegetables was identified. The dietary pattern was correlated with triglycerides (rcontrols=0.32, rPCOS=0.41), triglycerides/HDL-C ratio (rcontrols=0.35, rPCOS=0.44) and HDL-C (rcontrols=-0.22, rPCOS=-0.26) in both groups. The pattern was also positively correlated with waist circumference, total cholesterol (TC), LDL-C and systolic blood pressure in the controls. After adjustment for age and BMI, dietary pattern was associated with triglycerides (βcontrol=0.22, p=0.003 βPCOS=0.48, P=0.001) and triglycerides/HDL-C ratio (βcontrol= 0.23, P=0.002 βPCOS= 0.52, P=0.001) in both groups. The dietary pattern was inversely associated with HDL-C in both groups, but the association was attenuated by adjusting for age and BMI in the PCOS group. Conclusion: High adherence to the dietary pattern was associated with cardiometabolic risks in controls and to a lesser degree in the PCOS group.