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Background: The quality of food service is vital to patients' experiences in care and recovery in hospitals. This study aimed to identify opportunities for improving hospital food services to enhance overall patient experiences and outcomes., Methods: This retrospective cross-sectional study uses the Adult Admitted Patient Survey in 2019. Adult patients discharged from acute or rehabilitation care across 75 public hospitals were surveyed about their in-hospital experiences, including ratings of hospital food services, overall ratings of hospital care, complications acquired, and delayed discharge due to feeling unwell. Population weighting was applied in descriptive and multivariable logistic regression analyses. We used adjusted odds ratios (AORs) and 95% confidence intervals (CIs) to estimate the association between hospital food service and the overall rating of hospital care and two recovery outcomes., Results: Eight in ten participants (weighted, 16,919/21,900) consumed food in a hospital [mean age: 60.6 years (SE:0.5; SD: 18.3), 53% female]. Compared to a fair rating, adults who rated "poor/very poor" of hospital food service were 2.7 times more likely to report dissatisfaction with overall care in the hospital [Adjusted Odds Ratio (AOR) (95% CI): 2.73 (1.49, 4.99)], 1.4 times more likely to report complications [AOR:1.43 (1.11, 1.83)] and 1.9 times more likely to report delayed discharge [AOR 1.85 (1.30, 2.62)]. More moderate ratings were associated with attenuation of risk for these outcomes. Furthermore, the magnitude of the effect for these associations was more substantial among patients from non-English-speaking backgrounds (n = 1,759) after controlling for patient characteristics. Food service attributes, including received food as ordered, food delivered within reach, the taste of the meals, and meal interruption, were significant factors for the outcomes assessed., Conclusion: These findings underscore the importance of patients' positive experiences of hospital food service in recovery outcomes and identify several food service indicators that can be used to monitor and improve patient experiences and recovery outcomes in hospitals., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest. BT and DW are employees of the Bureau of Health Information, New South Wales, Australia., (Copyright © 2024. Published by Elsevier Ltd.)