Mexico is facing the double burden of malnutrition, and adolescents are not an exception. Diet plays an important role, both in causing overweight and undernutrition. This study aimed to describe the dietary patterns (DPs) of Mexican adolescents and to examine its association with nutritional status using data from adolescents aged 12-19 years (n = 7380) from the National Survey of Health and Nutrition (ENSANUT-2006). Principal component analysis was used to derivate the DPs. Associations between DP and nutritional status were determined by prevalence ratio (PR). Four DPs were identified: nontraditional and breakfast-type, Western, plant-based, and protein-rich. The prevalence of overweight and obesity was higher in adolescents who scored high on the Western pattern (PR: 1.15, 95% CI: 1.08-1.21) or on the plant-based pattern (PR: 1.09, 95% CI: 1.03-1.17). The Western pattern was positively associated with anemia in girls (PR: 1.18, 95% CI: 1.03-1.35), while the nontraditional and breakfast-type pattern was inversely associated with anemia in adolescents aged 12-15 years (PR: 0.87, 95% CI: 0.76-0.99) and in girls (PR: 0.84, 95% CI: 0.75-0.97). The Western and plant-based patterns were simultaneously associated with overweight-obesity and at least one indicator of undernutrition. In the context of the double burden of malnutrition, dietary advice must consider malnutrition in all its forms.