Multiple sclerosis (MS) is associated with changes in quality of life, disability, fatigue and anthropometric measurements. The important relationship of dietary patterns with such clinical manifestations was not completely investigated. The goal of this study was to define the dietary patterns and their association with systemic inflammation, Health-Related Quality Of Life, disease severity, Relapse Rate, severity of fatigue and anthropometric measurements in MS subjects. This cross-sectional study was conducted in 261 MS patients (mean age 38.9 ± 8.3). Dietary patterns were explored by a Food Frequency Questionnaire. Serum hs-CRP, Multiple Sclerosis Quality Of Life-54 item questionnaire, Extended Disability Status Scale, Fatigue Severity Scale and Visual Analog Fatigue Scale, Relapse Rate, Height, Weight and Deurenberg Equation were also used as tools. Data were analyzed by SPSS, and using ANOVA, Tukey, Chi-square and ANCOVA tests. Fruits, Vegetables, Low fat dairy-based pattern and Mediterranean-Like pattern were associated with lower serum hs-CRP ( = 6.037,  < 0.01), higher Physical and Mental Health Composite Scores (  < 0.001), lower attacks ( = 4.475,  < 0.05), lower acute and chronic fatigue ( = 5.353 and  = 7.011, respectively,  < 0.01), lower BMI ( = 7.528,  < 0.01) and Percent Body Fat ( = 6.135,  < 0.01); but no difference was observed about EDSS across the patterns. Adherence to healthy dietary patterns may reduce systemic inflammation, severity of fatigue, MS attacks, improved quality of life and balance weight especially body fat in MS patients.