Objectives: The objectives of this study were to investigate the association between dietary patterns and dyslipidemia among middle-aged and older adults in Hainan Province and to provide a scientific reference for regional dyslipidemia prevention strategies. Methods: A multi-stage cluster random sampling method was used to conduct questionnaire surveys and physical examinations among 4748 middle-aged and older adults from five regions in Hainan Province. Dietary patterns were derived using a food frequency questionnaire and factor analysis. Dietary-pattern scores were categorized into quartiles from lowest (Q1) to highest (Q4) adherence, with Q1 as the reference group. Logistic regression models were used to examine the associations between dietary patterns and four types of dyslipidemia. Results: A total of 4748 participants were enrolled, of whom 3321 (69.9%) had dyslipidemia. After adjusting for multiple confounders, compared with Q1, the meat-based dietary pattern at Q4 was positively associated with dyslipidemia (OR = 1.380, 95% CI: 1.102–1.729). The fruit-and-vegetable pattern was inversely associated with dyslipidemia at Q2 (OR = 0.800, 95% CI: 0.677–0.945), Q3 (OR = 0.790, 95% CI: 0.663–0.941), and Q4 (OR = 0.630, 95% CI: 0.519–0.765). The cooking-oil and wheat pattern was inversely associated with dyslipidemia at Q2 (OR = 0.843, 95% CI: 0.682–0.980) and Q4 (OR = 0.818, 95% CI: 0.715–0.993). Conclusions: The meat-based dietary pattern was positively associated with dyslipidemia, whereas the fruit-and-vegetable pattern and the cooking-oil and wheat pattern were inversely associated with dyslipidemia. These findings suggest that dietary patterns characterized by higher consumption of fruits, vegetables, and unsaturated fatty acids were inversely associated with dyslipidemia in this population.