© 2017, W. Montague Cobb-NMA Health Institute. Introduction: Obesity and chronic diseases disproportionately affect African-American women in the rural South (US) and may be influenced by adherence to a typical Southern-style diet. There is a need to examine dietary patterns of this population and to determine if consumption of nutritionally rich foods like nuts is associated with consumption of other nutritious foods. The objectives of this study were to identify (1) dietary patterns of overweight/obese African-American women in the rural South; (2) the role that nuts play in the diet; (3) and adherence to federal food group recommendations across dietary patterns. Methods: Secondary data analysis of two baseline 24-h dietary recalls was performed on 383 overweight/obese African-American women enrolled in a weight loss intervention in Alabama and Mississippi between 2011 and 2013. Cluster analysis identified dietary patterns. t tests and chi-square tests tested demographic and dietary differences across clusters. The proportion of women in each cluster who met federal recommendations for fruit, vegetable, nuts, added sugar, and sodium intake was calculated. Results: Two dietary patterns were found. Nut intake frequency was higher in cluster 2 (P < .001), which was characterized by a higher intake frequency of fruits and vegetables, but high mean daily intake of added sugar (12.26 ± 7.67 tsp) and sodium (2800 ± 881 mg). Ninety-two percent of participants in this cluster consumed red/processed meats daily. Conclusion: Even among women in this population who consume a more plant-based dietary pattern containing nuts, there is still a need to decrease intake of added sugar, sodium, and red meat.