Purpose <p>Skeletal dysplasias are a heterogeneous group of 771 rare diagnoses, that present short stature as a common feature. Despite the importance of nutrition in health management, food literacy in this population remains largely unexplored. This study aimed to assess the level of food literacy among Portuguese adults with skeletal dysplasia.</p> Methods <p>A cross-sectional observational study was conducted among adults (&gt; 18 years) with skeletal dysplasia (<i>n</i> = 43, 30 female). Data were collected through an online questionnaire comprising two sections: sociodemographic and clinical information and the Portuguese version of the Food Literacy Scale (FLS). The FLS covers three dimensions: literacy about the nutritional composition of food, literacy about labelling and food choices, and literacy about healthy eating practices. Food literacy scores were calculated as percentage indices. Descriptive statistics with 95% confidence intervals and subgroup comparison by sex and age were performed.</p> Results <p>Mean overall food literacy score was 60.8% (CI 95%: 54.7–66.9). Among the three dimensions, the highest mean score was observed for healthy eating practices, 62.0% (CI 95%: 56.4–67.6), and the lowest for labelling and food choices, 59.0% (CI 95%: 51.1–66.9). No statistically significant differences were found in overall food literacy or in any of its dimensions according to sex or age. Participants reported greater difficulty with recommended protein amounts, interpreting and using food labels, adhering to the Mediterranean diet, and recommended portion sizes.</p> Conclusions <p>Adults with skeletal dysplasia in Portugal showed modest food literacy scores, mainly in domains related to food labelling and food choices. Tailored nutrition education strategies and more easily accessible food-related guidance may help address the specific literacy gaps identified in this population.</p>