Introduction: The Western Diet (WD) is associated with deleterious processes linked with chronic disease and may play a role in the pathophysiology of heart failure (HF). Trimethylamine-N-oxide (TMAO) is a diet-linked metabolite that contributes to inflammation and is associated with higher TNF-α, especially in HF populations. The dietary inflammatory index (DII) score measures the inflammatory potential of a diet and the inflammatory effects of foods. More studies are needed to determine how the WD impacts immunological pathways and cytokines in the context of clinical and population characteristics. Purpose: The aim of this study was to explore associations between the WD, DII, TMAO, and TNF-α in Black patients living with HF. Methods: Thirty Black participants (mean age 55.3, 67.7% women) with HF were included in this study. TMAO and TNF-α levels were analyzed from dried blood spots using immunoassays. Participants completed a Food Frequency Questionnaire (FFQ) from which a DII score was derived. Food groups and nutrients, like choline, were measured with the FFQ. Sociodemographic variables were measured. Analyses included correlational and inferential statistics. Results: Mean DII score was -.38 revealing an overall anti-inflammatory diet with higher inflammatory scores among men (-.23) as compared to women (-.43). Women consumed greater kilocalories with more saturated fat, sodium, dairy, sugar, and fruit while men consumed more cholesterol, choline, proteins, alcohol, legumes, poultry, red meats, eggs, and phosphatidylcholine. DII score was negatively correlated with dietary choline (r= -.73, p<.001), but did not correlate with TMAO or TNF-α. TNF-α and TMAO were positively related (r=.30, p=.057). Conclusions: This sample of well-educated HF patients from a busy HF referral center did not consume a highly pro-inflammatory diet, yet our findings provide insight for specific food groups such as those with choline. In patients with HF, it is important to monitor intake of inflammatory foods and appreciate that increasing age may play a role in the retention of dietary metabolites. Further study of these relationships in patients with HF could lead to tailored dietary educational interventions based on dietary patterns, age, and cultural relevance.