Background <p>Anaemia is prevalent during pregnancy in Fiji. In many countries, inadequate nutrient intake is associated with anaemia during pregnancy. We aimed to describe the relationship between dietary patterns and anaemia amongst pregnant women in Fiji.</p> Methodology <p>A hospital-based, age-matched case-control study was conducted in the Antenatal Clinic at the main hospital in Suva, Fiji. Anaemia was defined as a haemoglobin concentration of less than 11.0 g/dL in trimesters 1 and 3, and less than 10.5 g/dL in trimester 2. Dietary variables were assessed using a semi-quantitative food frequency questionnaire, primarily reflecting late-pregnancy intake. Reduced-Rank Regression was employed to identify dietary patterns. Hierarchical multivariable conditional logistic regression models were used to assess the relationship between dietary patterns and anaemia in pregnancy.</p> Results <p>We enrolled 52 cases and 52 controls. The adjusted odds of anaemia decreased among women who were employed (aOR = 0.20, 95% CI: 0.11–0.37), had at least four antenatal visits (aOR = 0.30, 95% CI: 0.01–0.60), or did not drink milk with main meals (aOR = 0.04, 95% CI: 0.01–0.63). As the intake of vitamin B9 (aOR = 0.85, 95% CI: 0.76–0.98), vitamin B12 (aOR = 0.40, 95% CI: 0.17–0.95), or iron (aOR = 0.42, 95% CI: 0.22–0.80) increased, the odds of anaemia decreased. The odds of anaemia were reduced (aOR = 0.35, 95% CI: 0.10–0.96) for women with high intakes of fruit, vegetables, fish, and nuts, along with a low intake of organ meats, and increased (aOR = 1.21, 95% CI: 1.03–4.02) for women with high intakes of fruit but low intakes of green leafy vegetables, nuts, cereals, and animal protein.</p> Conclusion <p>In Fiji, both non-dietary and dietary factors are associated with the risk of anaemia during pregnancy. Preventing anaemia in pregnancy should focus on improving employment opportunities, promoting antenatal care visits, and encouraging nutrient-rich dietary habits.</p>