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Abnormal glucose tolerance (AGT), which includes type 2 diabetes and pre-diabetes, is highly prevalent in women post gestational diabetes mellitus (post-GDM). Dietary patterns have been associated with the risk of developing AGT in women post-GDM, but evidence in Asian populations is sparse. This study aimed to determine the association between a posteriori dietary patterns and AGT in women post-GDM. This cross-sectional study recruited 157 women post-GDM (mean age 34.8 years) from Seri Kembangan Health Clinic and Universiti Putra Malaysia. AGT was diagnosed according to the Malaysian Clinical Practice Guidelines using a 75 g 2 h oral glucose tolerance test or HbA1c. Food intake was assessed using the 2014 Malaysian Adult Nutrition Survey food frequency questionnaire. Five dietary patterns were derived using principal component analysis: 'Unhealthy', 'Fish-eggs-fruits-vegetables', 'Cereals-confectionaries', 'Legumes-dairy', and 'Meat-sugar-sweetened-beverages'. After adjusting for sociodemographic characteristics and total energy intake, the 'Cereals-confectionaries' dietary pattern was significantly associated with AGT (adjusted odds ratio 1.536, p = 0.049). Targeted lifestyle modification, including dietary intervention, for women post-GDM is warranted to reduce their risk of AGT and its complications.