Background & AimsWe examined the dietary inflammatory potential in patients who underwent liver transplantation (LTx), associated factors and its relationship with clinical outcomes ten years after the initial evaluation. MethodsDietary Inflammatory Index (DII®) scores were generated from data derived from the 24-hour recall in 108 patients. ResultsPatients with higher DII scores (highest tertile), indicating a pro-inflammatory diet, had significantly higher serum LDL cholesterol (108.0 vs 78.2 mg/dL, p=<0.01) at the initial evaluation. However, DII scores did not significantly predict the occurrence of clinical outcomes after ten years of follow-up. Patient age was predictive of neoplasia (OR:1.05 95% CI:1.00-1.11; p=0.03). Higher BMI at the initial evaluation was associated with steatosis (OR:1.51; 95% CI:1.29-1.77; p<0.01), and smoking history was associated with the occurrence of cardiovascular events (OR:7.71; 95% CI:1.53-38.79; p=0.01). Conclusions: A pro-inflammatory diet was associated with higher serum LDL cholesterol in the initial evaluation but may not be strongly related to clinical outcomes during long-term follow-up.