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Background: Abdominal aortic aneurysms (AAAs) develop in up to 8% of men and 6% of women over a lifetime. Although they typically remain asymptomatic, rupture of an AAA carries high mortality. Smoking and hypertension have been identified as modifiable risk factors for developing an AAA. The role of diet, however, is yet unclear.Objective: To evaluate the relationship between adherence to a DASH-style dietary pattern and the risk of incident AAA in a large, community-based cohort of middle-aged adults.Methods: Dietary intake was assessed via a 66-item FFQ at two visits in 14,322 participants enrolled in the ARIC study (Atherosclerosis Risk in Communities) without clinical AAA, incomplete dietary/covariate information or extreme energy intake at baseline. Adherence to a DASH-style dietary pattern was assessed using a previously developed dietary scoring index. Participants were followed for incident clinical AAAs using hospital discharge diagnoses, Medicare outpatient diagnoses, or death certificates through December 31, 2011. Cox proportional hazards models with covariate adjustment were used to estimate hazard ratios (HR) with 95% confidence intervals (CIs).Results: During a median follow-up of 23 years, there were 539 incident AAA cases. Participants with a DASH diet score in the highest quintile had a 39% lower risk to develop AAAs than those in the lowest score quintile (HRQ5 vs. Q1: 0.61; 95% CI 0.45, 0.84; ptrend =0.004) after adjusting for sociodemographics, total caloric intake, smoking, physical activity, BMI, abdominal obesity, diabetes, hypertension, hypercholesterolemia and cardiovascular disease. Higher intake of fruits, vegetables, whole grains, low-fat dairy, and nuts and legumes was related to a decreased risk for AAA.Conclusions: Greater adherence to a DASH-style dietary pattern was found to be associated with lower incidence of AAA. Higher consumption of fruits, vegetables, whole grains, low-fat dairy as well as nuts and legumes may help to decrease the burden of AAA in U.S. adults.