The Western dietary pattern appears to confer diabetes risk, but the role of dietary patterns in Asian populations remains unclear. We investigated the association between major dietary patterns and the glucose tolerance status of Japanese men. Abnormalities included impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes. Subjects were 2106 Japanese men who were administered a 75-g oral glucose tolerance test at their preretirement health check-ups. Information about diet was obtained using a 74-item FFQ before the test. Three dietary patterns were generated by factor analysis: 1) a high-dairy, high-fruit and -vegetable, high-starch, low-alcohol pattern; 2) an animal food pattern; and 3) a Japanese pattern. We used logistic regression analysis to estimate odds ratios (OR) with adjustment for potential confounding variables. A significant inverse association was found for the high-dairy, high-fruit and -vegetable, high-starch, low-alcohol pattern (P for trend < 0.0001); the OR of having a glucose tolerance abnormality (impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes) for the 2nd, 3rd, and 4th quartiles were 0.80 (95% CI = 0.62-1.04), 0.71 (95% CI = 0.54-0.92), and 0.51 (95% CI = 0.38-0.67), respectively, compared with the lowest quartile. The inverse association was consistent for each glucose tolerance abnormality as well as across subgroups stratified by risk factors for diabetes. The Japanese dietary pattern was positively associated with impaired glucose tolerance (P for trend = 0.048). A dietary pattern characterized by frequent consumption of dairy products and fruits and vegetables but low alcohol intake may be associated with a decreased risk of developing a glucose tolerance abnormality.