Introduction: The benefits of plant-based diets may depend on the type of plant; unhealthy plant foods, such as sugar and refined grains, have detrimental health consequences. Micronutrients in plants decrease inflammation and are essential for proper immune function. Deficiencies in these nutrients can contribute to a pro-inflammatory state and may increase risk of infection. Methods: We conducted a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) Study. Participants completed food frequency questionnaires in 1993-1996 (visit 3). We used reported intakes to calculate a plant-based diet index (PDI), healthy plant-based diet index (hPDI), and an unhealthy plant-based diet (uPDI). Active surveillance is conducted for all hospitalizations. We used Cox models to examine the associations of three plant-based diet indices (in quintiles) with risk of pneumonia and influenza, and other infection-related hospitalizations identified by ICD codes. Results: In our sample of 11,956 adults there were 2522 hospitalizations with respiratory infections and 4308 hospitalizations with any infection during a median follow-up of ~22 years. The incidence of hospitalization with respiratory infections and any infection was lower among those adults consuming more plant-based foods (Table) . Higher hPDI was associated with a lower risk of hospitalization with any infection or respiratory infection. Higher PDI was associated with a lower risk of hospitalization with any infection. Significant associations were not observed with the uPDI. Conclusions: Adults who adhere to diets high in any plant foods, as well as healthy plant foods, have a lower risk of hospitalization with infections. Adherence to diets high in healthy plant foods specifically is associated with lower risk of hospitalizations with respiratory infections.