Background: Dietary carbohydrate, fiber and sugar intake has been shown to play a role in the etiology of breast cancer, but the findings have been inconsistent and limited to developed countries with higher cancer incidence. Objective: To examine the association of premenopausal and postmenopausal breast cancer risk with dietary carbohydrate, fiber and sugar intake. Materials and Methods: This population based case-control study was conducted in Malaysia with 382 breast cancer patients and 382 controls. Food intake pattern was assessed via an interviewer-administered food frequency questionnaire. Logistic regression was used to compute odds ratios (OR) with 95% confidence intervals (CI) and a broad range of potential confounders were included in analysis. Results: A significant two fold increased risk of breast cancer among premenopausal (OR $Q_4$ to $Q_1$=1.93, 95%CI: 1.53-2.61, p-trend=0.001) and postmenopausal (OR $Q_4$ to $Q_1$=1.87, 95%CI: 1.03-2.61, p-trend=0.045) women was observed in the highest quartile of sugar. A higher intake of dietary fiber was associated with a significantly lower breast cancer risk among both premenopausal ($ORQ_4$ to $Q_1$=0.31, 95%CI: 0.12-0.79, p-trend=0.009) and postmenopausal ($ORQ_4$ to $Q_1$=0.23, 95%CI: 0.07-0.76, p-trend=0.031) women. Conclusions: Sugar and dietary fiber intake were independently related to pre- and postmenopausal breast cancer risk. However, no association was observed for dietary carbohydrate intake.