The association of dietary nutrient patterns and sperm motility is not yet well elucidated, and previous studies have just focused on the isolated nutrients. This case-control study examined the association of nutrient patterns with asthenozoospermia among Iranian men. In total, 107 incident asthenozoospermic men and 235 age-matched controls were interviewed through the infertility clinics in Tehran, Iran, from January 2012 to November 2013. Semen quality data were analysed according to the fifth edition of WHO guideline. Nutrient patterns were identified using principal component analysis based on semiquantitative 168-item food frequency questionnaires. All nutrient intakes were energy-adjusted by the residual method. In principal component analysis, three dietary patterns emerged. The first pattern, which was high in vitamin E, vitamin D, vitamin C, zinc, folate, total fibre, selenium and polyunsaturated fatty acids, was significantly associated with lower risk of asthenozoospermia. After adjustment for potential confounders, participants in the highest tertile of the first pattern scores had 51% lower risk of asthenozoospermia compared with those in the lowest (p-trend: .004). Our findings suggest that adherence to the pattern comprising mainly of antioxidant nutrients may be inversely associated with asthenozoospermia.