Food is the main source of cadmium (Cd) exposure in non-smoking populations. We examined maternal diet in pregnancy as predictor of blood Cd (BCd) in women from the Avon Longitudinal Study of Parents and Children (ALSPAC). Women reported on frequency of consumption of 43 foods and drinks, later combined into 10 groups: meats; fish; pulses; nuts; soybean products; root vegetables; leafy greens and green vegetables; breads and cereals; cakes and biscuits; pastas/rice. PCA was used to derive five dietary patterns: ‘health conscious’ (high in salad, fruit, rice, pasta, oat and bran-based breakfast cereals, fish, pulses, fruit juices and non-white bread); ‘traditional’ (high in vegetables and red meat and poultry); ‘processed’ (high in high-fat processed foods, such as meat pies, sausages and burgers, fried foods, pizza, chips and baked beans); ‘confectionery’ (high in foods with high sugar content: chocolate, sweets, biscuits, cakes and other puddings) and ‘vegetarian’ (high in meat substitutes, pulses, nuts and herbal teas; low in red meat and poultry). BCd was measured via ICP-MS in whole blood taken in early pregnancy (median 11 wks). Samples <LOD (0.2 µg/l) were assigned (LOD/√2) and included in analyses. BCd was dichotomized at median, 0.29 µg/l. A priori confounders included: pre-pregnancy BMI, estimated energy intake, alcohol consumption, smoking status, hemoglobin, age, educational attainment, material deprivation. 2169 women had complete data. We modeled the likelihood of having BCd >median in relation to diet. Sensitivity analysis excluded smokers. Closer adherence to the ‘health conscious’ pattern (covariate-adjusted OR [95% CI]: 0.56 [0.39-0.81]), frequent consumption of leafy greens and green vegetables (0.72 [0.56-0.92]) or meat (0.66 [0.46-0.95]) were associated with lower likelihood of elevated BCd compared with reference groups. Sensitivity analysis mirrored main findings. Adherence to a healthy diet in pregnancy is related to lower Cd levels.