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Background Gestational diabetes mellitus (GDM) causes many problems for mother and her neonate. A healthy diet plays an important role in preventing GDM. This study aimed to investigate the relationship between major dietary patterns and the GDM. Methods 386 healthy and 306 GDM pregnant women (total 693) completed this case-control study. Basic information and anthropometric indices were recorded, and a food frequency questionnaire was completed. For extracting major dietary patterns, the principal component analysis was performed. Multivariable logistic regression models were used to examine whether specific dietary patterns are associated to the GDM. Results Four dietary patterns were identified: “fruits and dairy products”, “red meat and plant-based foods”, “snacks and high-fat foods” and “carbohydrate-rich foods”. Among these major extracted dietary patterns, “fruits and dairy products” showed an inverse association to the GDM (odds ratio adjusted for confounders: 0.50, confidence interval: 0.284–0.882, p-trend = 0.019, for highest vs. lowest quartile). Conclusions It seems using a healthy dietary pattern such as “fruits and dairy products” may decrease GDM risk. Graphical abstract