The quality of foods we consume may be an important risk factor for breast cancer (BrCa); however, relations between quality of food metrics and BrCa risk have not been systematically investigated. The purpose of this study was to examine the association between food quality score (FQS) by assessing the intake of healthy and unhealthy food and the odds of (BrCa) among Iranian women. This hospital-based case-control study was carried out on 150 women with pathologically confirmed breast cancer within the past three months and 150 healthy controls that were age-match from the Cancer Research Center, Imam Khomeini hospital, Iran. Participants were interviewed to obtain data relating to diet (using a 147-item validated FFQ) and BrCa risk factors. We found a significant association between adherence to the FQS and odds of breast cancer in the fully adjusted model (OR: 0.58; P = 0.04) and in premenopausal women in the fully adjusted model (OR: 0.45; P = 0.02); however, we did not observe any association between postmenopausal women in the adjusted model (OR: 0.76; P = 0.5). We also failed to observe any association between healthy (p = 0.3) and unhealthy subgroups (p = 0.3) of FQS. Our findings suggest that adherence to FQS may be associated with an increased risk of breast cancer in crude and adjusted models in overall and premenopausal women. However, we did not see any association between FQS and BrCa risk in postmenopausal women. Prospective cohort studies are needed to confirm these findings.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1957136 .