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Background: Gallstone disease is one of the most common digestive diseases in developed and developing countries. Recent studies have expressed evidence in the context of the role of nutrition in the gallstone disease etiology. Thus, the main objective of present study was to investigate dietary patterns in patients with gallstone among those admitted to Imam Reza hospital in Mashhad (Northeastern Iran). Methods: In this case-control study conducted in 2016 in Mashhad, demographic data from of 94 patients with gallstones and 151 healthy controls matched for age, gender and socioeconomic variables was gathered via interviews and questionnaires. To determine the dietary patterns a valid and reliable 160-item semi-quantitative food frequency questionnaire was used. Nutritional software Nut 4 was used to analysis FFQ. Statistical tests and questionnaire analysis were performed by Nut 4 software (α = 0.05). Findings: Two major dietary patterns were identified: unhealthy (red meat, high-fat dairy, desserts, sugar, sweets, fast food, soft drink, snacks, sweet coffee, chowder, tea, fried potatoes, refined grains, egg, legume and potato), healthy (fish, fruits, vegetables, whole grains, poultry, nuts, dried fruits, dark coffee and low-fat dairy). Weight, waist circumference, and BMI had a direct relationship with gallstone. Conclusion: This study showed that unhealthy dietary pattern, the consumption of TFA, SFA, legume and coffee, smoking and high body mass index increase the risk of gallstone. Moreover, healthy dietary pattern, rich sources of vitamin C, fruits and vegetables do not contribute to gallstone.