Background and objectives: The application of factor analysis methodology to dietary patterns has recently become of considerable interest in nutritional epidemiology. Rather than considering nutrients or foods individually, pattern analysis provides an alternative approach to study highly correlated food groups commonly consumed. In this study we tried to identify major dietary patterns in our study population in the Kurdistan Province, Iran, and determine their associations with the risk of esophageal squamous-cell carcinoma in a hospital-based case-control study. Materials and methods: In this case-control study, 47 patients with esophageal squamous-cell carcinoma and 96 controls were interviewed to obtain information on general characteristics, physical activity, and food consumption frequency (125 food items). Following classification of food items in groups, factor analysis was used to identify possible dietary patterns, and then the odds ratio for esophageal squamous-cell carcinoma was estimated. The software used was SSPS-14. Results: Two major dietary patterns were identified: Pattern1: the healthy dietary pattern (including nuts, fruits, green leafy vegetables, yellow vegetables, other vegetables, tomatoes, olives, low-fat dairy products, fish, Doogh (a traditional buttermilk), and cabbages), and Pattern 2: the western dietary pattern (including hydrogenated fats, sugar, sweets and desserts, salt, pickles, eggs, soft drinks, tea, and small amounts of liquid oil). After adjustment for confounding factors such as age, sex, years of education, body mass index, physical activity, symptomatic gastroesophageal reflux, and smoking, a high score of Pattern 1 was associated with a reduced risk esophageal squamous-cell carcinoma by 67% (high second median vs. low 1st median, OR=0.33, 95%CI=0.12-0.86), whereas the Pattern 2 diet significantly increased the risk of the disease (high second median vs. low 1st median, OR=9.8, 95%,CI=3.2-29.7; p<0.001). Conclusion: Our results suggest that a healthy diet tends to reduce the risk of esophageal squamous-cell carcinoma, whereas a western-type diet increases the risk of this kind of cancer.