Purpose of Review <p>This review examines the potential role of ultra-processed food (UPF) consumption as a modifiable risk factor in substance use and substance use disorders (SUDs). We explore how UPF may influence brain function, decision-making, reward sensitivity, and relapse vulnerability, with an emphasis on overlapping neurocognitive mechanisms between UPF consumption and SUDs.</p> Recent Findings <p>UPF overstimulate reward-related brain regions and disrupt prefrontal executive functions, creating a neural imbalance that mirrors patterns observed in individuals with SUDs. These effects may promote impulsivity, craving, and compulsive reward-seeking, factors that contribute to both substance use initiation and relapse. Emerging cross-sectional and longitudinal evidence links greater UPF consumption with higher rates of alcohol, tobacco, and cannabis use in adolescents, and with lower quality of life, increased impulsive decision-making, and lower odds of being in remission among adults in recovery, although the latter requires further investigation. </p> Summary <p>Although the current evidence base is largely cross-sectional, except for one recent study, and relies on self-reported diet measures, it consistently highlights the behavioral and cognitive overlap between UPF consumption and substance use with large sample sizes. Recognizing UPF intake as a relevant factor in SUD etiology and recovery may offer novel opportunities for integrative treatment strategies. At a minimum, researchers and practitioners should consider examining dietary patterns of individuals at risk for substance use and those in SUD recovery. Future research should prioritize longitudinal and intervention-based studies to clarify causal pathways and identify actionable dietary targets for improving recovery outcomes.</p>