Prevailing dietary patterns and their association with nutritional outcomes are poorly understood, particularly for children in Korea. Our purposes were to identify major dietary patterns and to examine their associations with overweight among young children in Korea. For 1441 preschool children, usual diet was assessed by a FFQ, from which thirty-three food groups were created and entered into a factor analysis. We identified three dietary patterns by relative intake frequency of (1) vegetables, seaweeds, beans, fruits, milk and dairy products (Korean healthy pattern); (2) beef, pork, poultry, fish and fast foods (animal foods pattern); and (3) ice cream, soda, chocolate, cookies and candies (sweets pattern). The Korean healthy pattern was associated with better health status. As compared with the lowest quintile, the multivariate-adjusted OR of the highest quintile for health status inferior or similar to their peers was 0.59 (95 % CI 0.42, 0.84). Likelihood of being overweight was higher among those in the highest quintile (OR 1.77 (95 % CI 1.06, 2.94)) v. the lowest quintile regarding the animal foods pattern. These findings suggest that major dietary patterns are predictors of overweight and health status in Korean preschool children.