Nutrition affects bone health status. However, analysis of the dietary patterns gives insights into which particular combination of foods may influence nutritional status and bone health. The aim of this study was to explore the associations between dietary patterns, bone mineral density (BMD) and T-scores, and body composition in New Zealand postmenopausal women. This cross-sectional study examined 125 postmenopausal women aged between 54 and 81 years. Body composition, BMD and T-scores were determined using dual-energy X-ray a bsorptiometry (DXA). Diet composition was assessed using a validated food frequency questionnaire (FFQ) composed of 108 food items, from which 34 food groups were created. Dietary patterns were identified by principal component analysis. The bone and body composition data including skeletal sites T-scores, waist circumference, BMI and body fat percentage were regressed onto the dietary patterns. Four dietary patterns were identified; the milk and milk-rich beverages dietary pattern, the dessert, cheese and red meat dietary pattern, the fruit-rich, biscuit and crackers dietary pattern and the oily fish, sports drink and seafood-rich dietary pattern. The milk and milk-rich beverages dietary pattern was significantly positively associated with spine T-score (r = 0.247, P = 0.008), and not whole-body BMD (r = 0.182, P = 0.051). The oily fish, sports drink and seafood-rich dietary pattern was marginally negatively associated with waist circumference (r = -0.157, P = 0.094) and body mass index (r = -0.163, P = 0.081) and significantly associated with body fat percentage (r = -0.247, P = 0.008). Binary logistic regression indicated that intake of the milk and milk-rich beverages dietary pattern reduced the occurrence of osteoporosis [adjusted odds ratio OR (95% CI): 0.589 (0.353, 0.982)]. A dietary pattern characterized by a high factor loading of milk and milk-rich beverages was positively associated with whole-body BMD and spine T-score, while the oily fish, sports drink, seafood-rich dietary pattern was inversely associated with total body fat percentage. Consumption of milk, even with coffee showed a positive association with bone health among postmenopausal women. Further longitudinal intervention studies is warranted to confirm effects of dietary patterns on skeletal body sites such as hip and femoral neck T-scores.