The objective of the present study was to investigate the association between food patterns and anaemia among Chinese adults. It was a cross-sectional household survey undertaken in 2002. The sample contained 2849 men and women aged 20 years and above, and had a response rate of 89·0 %. Factor analysis was used to identify food patterns based on a food-frequency questionnaire. Logistic regression was used to relate food patterns to anaemia. A four-factor solution explained 30·5 % of the total variance. After adjusting for socio-demographic factors and four distinct food patterns, the ‘traditional’ (rice, vegetable, wheat flour), ‘sweet tooth’ (drinks, cake) and ‘healthy’ (whole grains, fruits, vegetables) patterns were independently associated with anaemia. ‘Traditional’ and ‘sweet tooth’ patterns were positively associated with anaemia, whereas the association with ‘healthy’ food pattern was negative. No association was observed between the ‘macho’ pattern (meat and alcohol) and anaemia. Compared with the lowest quartile (Q1) of the ‘traditional’ pattern, the highest quartile (Q4) had a higher risk of anaemia (men: odds ratio (OR) 2·60, 95 % CI 1·38, 4·88; women: OR 3·40, 95 % CI 2·14, 5·39). For the ‘sweet tooth’ pattern, compared with the lowest quartile (Q1), the OR of the highest quartile was 2·34 (95 % CI 1·47, 3·73) for men and 2·02 (95 %CI 1·31, 3·13) for women. The fourth quartile of healthy food was associated with a lower risk of anaemia (men: OR 0·50, 95 % CI 0·31, 0·79; women: OR 0·51, 95 % CI 0·34, 0·75). Women in the north had a higher risk of anaemia (OR 2·49, 95 %CI 1·80, 3·43). Food patterns were associated with anaemia in this area with a high prevalence of anaemia.