Background <p>Vitiligo is a melanocyte-destructive depigmenting disease linked to immune inflammation, with diet potentially mediating inflammatory processes via immune dysregulation. However, the specific role of diet in vitiligo pathogenesis remains understudied.</p> Objective <p>To investigate the association between Dietary Inflammatory Index (DII) and vitiligo onset or progression, for developing novel prevention strategies.</p> Methods <p>A case-control study included 80 progressive vitiligo patients (2024 Jan-Mar, Shuguang Hospital) and 80 sex/age-matched controls. Dietary intake was assessed via semi-quantitative food frequency questionnaire (SQFFQ), with DII scores calculated. Logistic regression and Spearman analysis evaluated DII-vitiligo associations.</p> Results <p>Cases had significantly higher DII levels (Z=-2.054, <i>P</i> = 0.042). Each 1-unit DII increase correlated with a 23% higher vitiligo risk (OR = 1.23, 95% CI: 1.005–1.504, <i>P</i> = 0.044), with a positive Spearman correlation (<i>r</i> = 0.161, <i>P</i> &lt; 0.05).</p> Conclusion <p>Pro-inflammatory diets may increase the risk of vitiligo occurrence and development. Adjusting the dietary structure may help prevent and control the disease. This study provides a new basis for dietary interventions in vitiligo.</p> Limitations <p>Limitations include small sample size and reliance on global DII norms (lacking Chinese standards), warranting multi-center, large-scale studies.</p>