The aim of our study was to describe and compare nutritional status and food related behaviours in rural pregnant women of Li ethnicity as they had been divided into mountainous and costal groups by residential area. One hundred and ninety-six randomly selected healthy rural pregnant women of Li ethnicity for the mountainous group (MG), and eighty-two for the coastal group (CG) were recruited. Data were collected via demographic questionnaires, anthropometric measurements, food related behaviour questionnaires, five day dietary diaries and plasma folate tests. The mean (SD) age, years of education, and height of all participants were respectively 25.7 (3.99) years, 7.57 (2.45) years and 155 (5.04) cm, without significant group differences (p>0.05). Significant differences were shown in dietary intakes of protein, fat, carbohydrate, dietary fibre, thiamine, vitamin C, folate, potassium, sodium and magnesium between MG and CG (p<0.05). The prevalence of plasma folate deficiency differed significantly between groups (3.08% in MG vs 37.8% in CG, p<0.001). High prevalence of active or passive smoking (65.1% in MG vs 68.4% in CG), alcohol consumption (13.8% in MG vs 2.6% in CG), and betel quid chewing (19.6% in MG vs 53.9% in CG) were found in all participants. Differences in alcohol consumption and betel quid chewing rates between groups were also significant (p<0.05). In general, coastal Li pregnant women have a poorer plane of nutrition than their mountainous counterparts. Therefore, healthy diet and lifestyle education are urgently required and should be emphasised during routine prenatal care.