BACKGROUND: Students attending alternative high schools are an at-risk group of youth for poor health behaviors and obesity. However, little is known about their dietary practices. OBJECTIVE: To examine associations between sex, race/ethnicity, and socioeconomic status and selected dietary practices, including consumption of sugar-sweetened beverages, high-fat foods, and fruits and vegetables and fast-food restaurant use, among students attending alternative high schools. DESIGN: Population-based, cross-sectional study. SUBJECTS/SETTING: A convenience sample of adolescents (n=145; 52% men; 63% aged <18 years; and 39% white, 32% African American, and 29% other/multiracial) attending six alternative high schools in the St Paul/Minneapolis, MN, metropolitan area completed a survey. Students were participants in the Team COOL (Controlling Overweight and Obesity for Life) pilot study, a group randomized obesity prevention trial. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were used to describe dietary practices. Mixed model multivariate analyses were used to assess differences in dietary practices by sex, race/ethnicity, and socioeconomic status. RESULTS: Regular soda was consumed at least five to six times per week by more than half of students. One half of students reported eating or drinking something from a fast-food restaurant at least three to four times a week. African-American students had the highest consumption of sugar-sweetened beverages (P=0.025), high-fat foods (P=0.002), and highest frequency of fast-food restaurant use (P<0.025). Mean fruit/vegetable intake was 3.6 servings/day; there were no sociodemographic differences in fruit/vegetable consumption. Higher socioeconomic status was associated with a higher consumption of regular soda (P=0.027). CONCLUSIONS: Racial/ethnic and sex differences in the consumption of regular soda, high-fat foods, and fast-food restaurant use among alternative high school students underscores the importance of implementing health promotion programs in alternative high schools.