Purpose We hypothesized that major American dietary patterns are associated with risk for age-related macular degeneration (AMD). Design Cross-sectional study. Methods We classified 8103 eyes in 4088 eligible participants in the baseline Age-Related Eye Disease Study (AREDS). They were classified into control (n = 2739), early AMD (n = 4599), and advanced AMD (n = 765) by the AREDS AMD Classification System. Food consumption data were collected by using a 90-item food frequency questionnaire. Results Two major dietary patterns were identified by factor (principal component) analysis based on 37 food groups and named Oriental and Western patterns. The Oriental pattern was characterized by higher intake of vegetables, legumes, fruit, whole grains, tomatoes, and seafood. The Western pattern was characterized by higher intake of red meat, processed meat, high-fat dairy products, French fries, refined grains, and eggs. We ranked our participants according to how closely their diets line up with the 2 patterns by calculating the 2 factor scores for each participant. For early AMD, multivariate-adjusted odds ratio (OR) from generalized estimating equation logistic analysis comparing the highest to lowest quintile of the Oriental pattern score was ORE5O  = 0.74 (95% confidence interval (CI): 0.59–0.91; Ptrend  =0.01), and the OR comparing the highest to lowest quintile of the Western pattern score was ORE5W  = 1.56 (1.18–2.06; Ptrend  = 0.01). For advanced AMD, the ORA5O was 0.38 (0.27–0.54; Ptrend < 0.0001), and the ORA5W was 3.70 (2.31–5.92; Ptrend < 0.0001). Conclusions Our data indicate that overall diet is significantly associated with the odds of AMD and that dietary management as an AMD prevention strategy warrants further study.