ABSTRACT Background: Rheumatoid arthritis is a chronic inflammatory disease characterized by progressive joint destruction and systemic involvement. There is emerging evidence that lifestyle factors, potentially modifiable through diet, contribute to the risk of developing RA as well as influence its severity. Patterns of diet influence the cumulative effect of various foods and nutrients that have been related to immune modulation and inflammatory processes crucial in the pathogenesis of RA. Methods: Patients diagnosed with RA based on ACR criteria were selected for this cross-sectional study. The dietary intake of the participants was evaluated through a validated food frequency questionnaire (FFQ) and further categorized into specific dietary patterns through the use of principal component analysis (PCA). Disease activity was measured by use of the DAS28 score. Multiple regression models were used to study the relationship between food patterns and RA disease activity controlling for possible confounding factors like age, gender, BMI, and disease duration. Results: The two large dietary patterns distinguished were a Western-style pattern (high intake of red meat, processed foods, and sugar-sweetened beverages) and a Mediterranean-like pattern with high intake of fruits, vegetables, whole grains, and olive oil. After adjusting for confounders, the DAS28 score was inversely associated with a Mediterranean-like pattern at p<0.05; thus, less disease activity may be present among patients who consumed this dietary pattern. On the other hand, higher adherence to the Western style pattern was directly related to the DAS28 scores at p<0.05. Conclusion: Our results demonstrate the possibility that dietary interventions could influence disease activity in RA. Following a Mediterranean diet may have an anti-inflammatory effect on the disease course, thus making it less severe. These results stress the importance of including dietary counselling as part of holistic RA management.