Limited knowledge is available on dietary patterns and bladder cancer risk. We analyzed data from an Italian case-control study carried out between 2003 and 2014, including 690 incident bladder cancer cases and 665 hospital-controls. We derived nutrient-based dietary patterns applying principal component factor analysis on 28 selected nutrients. We categorized factor scores according to quartiles, and estimated the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) through logistic regression models, adjusted for major confounding factors. We identified four dietary patterns named &ldquo / Animal products&rdquo / , &ldquo / Vitamins and fiber&rdquo / , &ldquo / Starch-rich&rdquo / , and &ldquo / Animal unsaturated fatty acids&rdquo / . We found an inverse association between the &ldquo / Vitamins and fiber&rdquo / pattern and bladder cancer (OR = 0.70, 95% CI: 0.48&ndash / 0.99, IV versus I quartile category). Inverse relationships of borderline significance were also found for the &ldquo / Animal products&rdquo / and the &ldquo / Animal unsaturated fatty acids&rdquo / dietary patterns. No significant association was evident for the &ldquo / Starch-rich&rdquo / pattern. The current study allowed us to identify major dietary patterns in this Italian population. Our study confirms available evidence and shows that scoring high on a fruit-and-vegetables pattern provides beneficial effects on bladder cancer risk.