Background: Regional dietary variations in China are well-documented, but their mortality associations in local populations, particularly among individuals with type 2 diabetes (T2D) or hypertension, remain unclear. This study aimed to identify dietary clusters in Suzhou and investigate their associations with mortality. Methods: This prospective analysis included 53,269 participants aged 30-79 years from the China Kadoorie Biobank (CKB) Suzhou Wuzhong subcohort. The baseline diet was assessed via a food frequency questionnaire, and three dietary clusters were identified by K-means clustering of 10 food groups. Multivariable Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cardiovascular disease (CVD), diabetes-related, and cancer mortality, stratified by baseline health status, T2D, and hypertension. Results: During follow-up, 1263 deaths occurred among healthy adults, 351 in T2D, and 2410 in hypertension. The Traditional/Preserved-Heavy cluster was characterized by lower intake frequencies across most food groups and more frequent preserved vegetable intake; the Meat-Centric cluster by relatively moderate intake frequencies and higher meat and poultry intake; and the Plant-and-Dairy-Abundant cluster by relatively abundant overall dietary intake, more frequent intake of fresh fruit, dairy products, and soybean products, and less frequent preserved vegetable intake. With the Meat-Centric cluster (cluster 2) as the reference, the Plant-and-Dairy-Abundant cluster (cluster 3) in T2D was associated with lower all-cause (HR = 0.61, 95% CI: 0.44-0.85), CVD (0.47, 0.24-0.91), and diabetes-related mortality (0.25, 0.09-0.71). BMI modified the association with all-cause mortality in T2D (p interaction = 0.033). In hypertension, cluster 1 was linked to higher all-cause (1.13, 1.03-1.23) and CVD mortality (1.17, 1.00-1.37), whereas cluster 3 was associated with a lower risk of diabetes-related mortality (0.40, 0.16-0.98). Conclusions: A dietary habit rich in fruit, dairy products, soybean products, and less frequent preserved vegetable intake was associated with lower mortality risk, particularly in T2D patients, whereas a habit with lower overall intake and more frequent preserved vegetable intake was linked to higher mortality in hypertension participants. These findings should be interpreted in light of the accompanying socioeconomic and lifestyle differences across dietary clusters.